Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.
The behaviors associated with illness are different depend upon individuals even if Patients complaints same symptoms and have same disease. Understanding the patterns of those behaviors become one of the important elements in determining the diagnostic and treatment approaches and treatment compliance. The sick role plays a essencial part in abnormal illness behavior. The characteristics of abnormal illness behavior ran be applied to many parts in medicine. In case of the various kinds of functional disorders whose organic foundations are obscure and in applying the cognitive therapy, rehabilitation program and occupational therapy, the assessment and evaluation of the abnormal illness behvior is known to be beneficial. For improving the comprehensive psychiatric treatments which could be applied to the Koreans more effectively in patients with somatoform disorders and other various kinds of neurotic disorders further researches especially on the medico-historical and socio-cultural aspects of the illness behavior should be followed. And understanding the abnormal illness behavior would be helpful in enhancing the medical cost effectiveness.
The purpose of this study is to analyze the correlation between cognition, depression and leisure activity in elderly people above 65 years of age, and to improve their health and quality of life by providing baseline data for occupational therapy intervention. This investigation was performed on 118 elderly people above 65 years of age who lived in local community and two senior welfare centers. In order to collect the data, we used MMSE-K, KDS, Questionnaire for leisure activity. The depression of elderly people was negatively correlated with their cognition(p<.01) and leisure activity(p<.001), whereas cognition was positively correlated with their leisure activity(p<.01). In conclusion, the correlation between cognition, depression and leisure activity of elderly people appeared statistically significant. Therefore, leisure activity program should be designed through additional research and effectively provided in nursing home and community senior welfare center to prevent depression increase and cognitive decline.
2018 aged patient dataset (HIRA-APS), 33,821 patients admitted to long-term care hospitals were classified by major disease groups to identify the characteristics of medical use and provide effective policy data. First, it is necessary to operate specialized long-term care hospitals such as dementia, rehabilitation, hospice, and recovery specialization tailored to the characteristics of the patient's disease group. Second, the paralysis group, cerebrovascular disease group, and dementia group were the longest LOS and the cognitive impairment group is the longest by patient classification group, requiring medical demand and quality management for long-term patients. Third, the musculoskeletal disease group was the highest normal discharge, and support for the post-discharge home program is required in paralysis and cerebrovascular disease.
This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.
Eun, Baik-Lin;Kim, Seong Woo;Kim, Young Key;Kim, Jung Wook;Moon, Jin Soo;Park, Su Kyung;Sung, In Kyung;Shin, Son Moon;Yoo, Sun Mi;Eun, So Hee;Lee, Hea Kyoung;Lim, Hyun Taek;Chung, Hee Jung
Clinical and Experimental Pediatrics
/
v.51
no.3
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pp.225-232
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2008
The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child's age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.
Journal of Korean Society of Neurocognitive Rehabilitation
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v.10
no.2
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pp.35-44
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2018
This study was conducted to explore the effects of semi-structured $DIRFloortime^{(R)}$ treatment on the enhancement of language comprehension and information processing of children with high-performance autistic spectrum disabilities. We measured the general characteristics of the test subjects, which are level of autism, total intelligence, language comprehension and information processing indicators. The intervention method used was a semi-structured $DIRFloortime^{(R)}$ therapy using board game intervention program after revising and supplementing the expert content validity. A pre/post-test for a group was designed as a similar experiment and the pre/post test was initiated with the t certification at .05 of significance level. After initiating the program, the post test has shown that the language comprehension indicators showed statistically significant levels of difference (p<.001) and the information processing indicator also had a statistically significant effect (p<.001). There was a statistically significant difference (p<.001) in the level of verbal comprehension index after the program implementation, and statistically significant differences in the information processing index (p<.001). The semi-structured $DIRFloortime^{(R)}$ treatment using boardgames for enhancing the language comprehension and information processing indicators of children with high performance autistic spectrum disorder had a significant effect.
This study is an empirical study on the effect of wellness factors on the quality of life and subjective happiness of disabled workers, and aims to contribute to living a healthy life by experiencing wellness in the real life. This study used raw data of the 8th employment panel survey for the disabled, and explored factors such as physical wellness, emotional wellness, social wellness, cognitive wellness, and occupational wellness through exploratory factor analysis. And the wellness factors have a significant effect on the quality of life and subjective happiness of the disabled workers. The results showed that the five wellness factors had a positive (+) effect on the quality of life and subjective happiness of the disabled. Also, the quality of life has a significant effect on subjective happiness. In conclusion, it was confirmed that the quality of life and subjective happiness were improved only when the wellness of the disabled workers was increased. In the future, it is necessary to develop a wellness program suitable for the type of disability and to develop indicators that can be applied to real life situations.
This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.
Objective : The purpose of this study was to look at a systematic review on the effects of occupational reminiscence therapy in Dementia offered National Long term care Insurance. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from 2009 to 2013, using KERIS. Main words to examine are Dementia, Long term care service, Day care center, reminiscence therapy, occupational centered, etc. Results : 6 studies were selected, All of them were occupational reminiscence therapy. Reminiscence therapy can be devided into communication centered reminiscence therapy and occupational reminiscence therapy. The results demonstrated that the intervention significantly affected the maintenance cognitive skills and reminiscence skills, decreased depression, behavioral changes, improvement of communication and interaction skills and quality of life etc. of elderly people with dementia (p<.05). Conclusions : If occupational therapists can obtain knowledge and make a program for occupational reminiscence therapy, research in this field will be further developed. In the future study, the use of occupational reminiscence therapy applied to a variety of interventions and majority of patients is needed on occupational therapy.
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