Objective: Despite known associations between negative body image and health declines in chronic pain patients, few studies have examined longitudinal associations between psychological stress and perceived hand deformities. This study examined whether psychological distress was associated with hand deformities 4 years later and if rural and urban adults differed in the association. Design: A community-based cohort study. Methods: Community dwelling adults (mean age=51.97, 52.3% women) in a rural (n=2968) and urban area (n=2784) provided demographic data at baseline and, in the 4-year follow-up, responded to questionnaires about psychological distress. Perceived hand deformities were assessed at the 8-year follow-up. Linear regression was conducted to examine the effects of psychological distress on hand deformities and moderation by residential areas. Results: The perceived hand deformities were more likely among those with severe psychological stress, hand osteoarthritis, or any chronic disease condition (p<0.01) but less likely among those with younger age, higher education, or income (p<0.01). The regression results showed that psychological distress predicted more perceived hand deformities 4 years later even after adjusting for demographic and health covariates (p<0.01). The residential areas did not significantly moderate the association between distress and hand deformities. Conclusions: This study suggected that psychological distress may trigger later perception of hand deformities in both urband and rural adults. The findings indicate that stress management interventions that are customizable to regional contexts may be effective at preventing negative body image related health problems of community-dewelling adults.
The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.
Spatial and temporal changes of fish communities were studied at four study sites in the Cheonggye Stream from October 2005 to August 2006 after the rehabilitation process. During the survey period, 19 species in 6 families were sampled. Species Rhynchocypris oxycephalus and Zacco platypus were identified as dominant species. Korean endemic species such as Acheilognathus yamatsutae and Zacco koreanus were observed in the sites. Overall, species richness and abundance increased as time passes after the rehabilitation, reflecting colonization process of the fish community. Meanwhile species richness and abundance were higher at the downstream than at the upstream. Community indices such as dominant index, richness index and diversity index showed also similar spatial and temporal pattern. Nonmetric multidimensional scaling (NMDS), multivariate ordination technique, was used to analyze spatial and temporal variation of the fish communities, and the results showed spatial variation of fish communities with high species richness at downstream as well as the temporal variation of fish communities with high values of species richness and diversity index at later part of the study period, presenting colonization process of the fish community after the rehabilitation project.
Objective: The timed up and go (TUG) test is method used to determine the functional mobility of persons with stroke. Its reliability, validity, reaction rate, fall prediction, and psychological characteristics concerning ambulation ability have been validated. However, the relationship between TUG performance and community ambulation ability is unclear. The purpose of this study was to investigate whether the TUG performance time could indicate community ambulation levels (CAL) differentially in persons with chronic stroke. Design: Cross-sectional study. Methods: Eighty-seven stroke patients had participated in this study. Based on the self-reporting survey results on the difficulties experienced when walking outdoors, the subjects were divided into the independent community ambulation (ICA) group (n=35) and the dependent community ambulation group (n=52). Based on the area under the curve (AUC), the discrimination validity of the TUG performance time was calculated for classifying CAL. The Binomial Logistic Regression Model was utilized to produce the likelihood ratio of selected TUG cut-off values for the distinguishing of community ambulation ability. Results: The selected TUG cut-off values and the area under the curve were <14.87 seconds (AUC=0.871, 95% confidence interval=0.797-0.945), representing a mid-level accuracy. Concerning the likelihood ratio of the selected TUG cut-off value, it was found that the group with TUG performance times shorter than 14.87 seconds showed a 2.889 times higher probability of ICA than those with a TUG score of 14.87 seconds or longer (p<0.05). Conclusions: The TUG can be viewed as an assessment tool that is capable of classifying CAL.
Purpose: The purpose of this study was to identify the prevalence of depression and its risk factors among older adults using social service centers in one urban community. Methods: The participants were 326 older adults who were aged 60 and older in one urban Korean community. Depression was measured by Korean version of short form Geriatric Depression Scale. Results: The prevalence of depression was 33.74% in this study. Logistic regression analysis showed that older adults who were taking prescribed medications, experiencing more symptoms, being educated less than elementary school and having low family function were more likely to have depression as compared to their counterparts. Conclusion: The findings of this study were expected to promote the screening or preventing strategies for older adults at the risk of depression in the community-dwelling older adults.
Purpose: This study was conducted to develop a community capacity builded exercise maintenance program for frail elderly women. Methods: As a guideline to develop the exercise maintenance program, the intervention mapping framework, including needs assessment, setting program goals, selecting theory-informed intervention methods, producing program components, planning program implementation and evaluation, was used. Focus group interviews with public health nurses and frail elderly women were conducted for needs assessment. Intervention strategies and components were formulated based on community capacity theory. Results: The developed exercise maintenance program consisted of strategies focusing on leadership development, partnership construction, organization development, community systematization of dimension of community capacity. A exercise maintenance program using health leader, health contract, exercise pocketbook, rhythmic activity suiting song and self-help group was included. Conclusion: The intervention mapping method was found to be useful to develop theory-based valid and community capacity builded exercise maintenance strategies for frail elderly women.
Although the availability of home care rehabilitation services have been greatly increased since community-based rehabilitation was introduced to Korea, there is still a dearth of studies investigating the performance level of ADL (activities of daily living) for the physically disabled in the rural areas. The purposes of this study were to investigate the ADL performance level of disabled persons living at home in the rural areas of Wonju city, Korea, using FIM (functional independence measure) and to identify the specific areas of the ADL to be trained or evaluated by physical therapists or occupational therapists. 298 disabled people were interviewed by 10 physical therapy students. Analysis of the interviews indicated: 1) Forty seven point seven percent of the respondents were elderly-disabled persons whose ages were 61 years old or above, and 69.5% of respondents has the history of chronic disability period of 5 years or more. 2) FIM score of bathing, and stairs climbing showed severe dependent trend 3) FIM scores of self-feeding, urination, defecation, and comprehension ability were mildly dependent. These results revealed that functional evaluation/treatment for discharging from hospitals to the rural areas should be emphasized on the specific ADL performance areas such as bathing, and stairs climbing.
This study apply concept mapping to realize of client participation and self-determination in social welfare program for the mental disorders. They are relatively easily marginalized in decision-making process of their program. But realization of client participation and self-determination is directly connected with effect of service. For this reason, we confirmed the applicability of concept mapping in program planning that support client participation. Case of this study is social welfare program of B community psychiatric rehabilitation center located in the A city. This program is community interchange service for the mental disorders. Interchange type is to have a food with the mental disorder and the solitary elderly. We took advantage of the concept mapping to derive the outcomes that are expecting the mental disorders and mental health social workers. Concept mapping was proceeding in six steps; preparation stage ${\rightarrow}$ idea collection stage ${\rightarrow}$ structuralization stage ${\rightarrow}$ analysis stage ${\rightarrow}$ interpretation stage ${\rightarrow}$ application stage. Participants were a total of 25 people including the mental disorders and community psychiatric rehabilitation center employees. The participants produced 42 statements. Sorting results, the mental disorders produced 6 clusters; community psychiatric rehabilitation center employees produced 3 clusters. The mental disorders classified better detail than community psychiatric rehabilitation center employees. Two group were found gap of expected outcomes each other, went narrowed it. They agreed 3 expected outcomes finally. We identified empirically the usefulness of concept mapping to realize self-determination and program participation.
Purpose: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). Methods: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. Results: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. Conclusion: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.
This study aimed to evaluate the effect of a weekly circuit-group exercise program on functional performance, flexibility of the trunk and lower extremities, and balance in individuals with chronic stroke who are living in a community. Thirteen community-living individuals (eleven males and two females) with chronic stroke participated in this study. The group exercise program was set up as a weekly circuit application with four stations aiming to strengthen the muscles, increase endurance, improve flexibility, and enhance functional capacity. The average duration of a session was an hour, and the sessions were conducted once a week for six months for a total of 24 sessions. Assessments for functional performance, flexibility of the trunk and lower extremities and balance were conducted four times: before treatment, after one month of treatment, after four months of treatment, and after six months of treatment. There were significant improvements in functional performance and flexibility of the trunk and lower extremities in the given time frame. No significant improvement was observed in balance ability. The findings suggest that a weekly circuit-group exercise program has some benefits in terms of managing the physical symptoms of individuals with mobility problems after stroke. Therefore, this program can be adapted and employed as a community-based rehabilitation program for such patients. Further studies with various community-based treatments will be conducted to validate these findings.
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