• 제목/요약/키워드: Continuum of care

검색결과 21건 처리시간 0.033초

재가 중증 장애인의 지속적 재활 관리 실태와 재활 서비스 요구 (The Continuum of Rehabilitation Care and the Rehabilitation Services that are Needed by People with Severe Disabilities)

  • 장숙랑;김완호;이규범;김수경;임재영;이선자
    • Journal of Preventive Medicine and Public Health
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    • 제39권3호
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    • pp.263-269
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    • 2006
  • Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

A computational setting of calcium leaching in concrete and its coupling with continuum damage mechanics

  • Nguyen, V.H.;Nedjar, B.;Torrenti, J.M.
    • Computers and Concrete
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    • 제1권2호
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    • pp.131-150
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    • 2004
  • We present in this work a coupled phenomenological chemo-mechanical model that represents the degradation of concrete-like materials. The chemical behaviour is described by the nowadays well known simplified calcium leaching approach. And the mechanical damage behaviour is described by a continuum damage model which involves the gradient of the damage quantity. The coupled nonlinear problem at hand is addressed within the context of the finite element method. For the equation governing the calcium dissolution-diffusion part of the problem, special care is taken to treat the highly nonlinear calcium conductivity and solid calcium functions. The algorithmic design is based on a Newton-type iterative scheme where use is made of a recently proposed relaxed linearization procedure. And for the equation governing the damage part of the problem, an augmented Lagrangian formulation is used to take into account the damage irreversibility constraint. Finally, numerical simulations are compared with experimental results on cement paste.

지역별 암모니터링 지표 개발을 위한 다차원적 암모니터링 지표 프레임워크: 암 환자 생애 연속성에 기반하여 (Multidimensional Cancer Monitoring Index Framework for Developing Regional Cancer Monitoring Index: Based on Cancer Continuum)

  • 권정아;김재현;장지은;김우림;전미선;정승연;;신재용
    • 보건행정학회지
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    • 제30권4호
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    • pp.433-437
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    • 2020
  • Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.

Current and Future Role of the Gastroenterologist in GI Cancer Management

  • John M. Carethers
    • Journal of Digestive Cancer Research
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    • 제1권2호
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    • pp.78-81
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    • 2013
  • With advances in technology, advances in the understanding of biology of cancer, and the advent of improved and novel therapies, the role of the gastroenterologist has been modified greatly over the past 2 decades, and continues to be shaped by the knowledge, skill, and opportunity to capitalize on the unique position that gastroenterologists hold in the patient care continuum. The gastroenterologist is evolving from a "pure" diagnostician to an endoscopic surgeon, a geneticist, a nutritionist, an immunologist and chemotherapist, and palliative care physician.

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An Innovative Wellness Program Promoting Participation in Physical Activity of Community-Dwelling Frail Elderly

  • Choi, Bong-sam
    • 한국전문물리치료학회지
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    • 제24권3호
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    • pp.47-56
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    • 2017
  • Background: Given the potential benefits of wellness programs promoting physical activity of the community-dwelling frail elderly, it is recommended that comprehensive wellness programs combined with the component of physical activity. This may improve overall health and potentially lower the health care cost of the frail elderly. In general, the frail elderly residing in community or those after being discharged from hospitals are often committed to enhancing the status of participation in physical activity. Objects: The purposes of this study were to identify specific shortcomings of current wellness programs as part of continuum of community rehabilitation services and to propose alternatives for the care of the community-dwelling frail elderly. Through this study, geriatric health care professionals may be able to implement assessments and programs to successfully promote an effective continuum of care for the frail elderly. Methods: Article reviews were summarized and evaluated. Results: A model elaborating the relationship between components of successful wellness program and participation in physical activities for the community-dwelling frail elderly are recommended. First, periodic monitoring the levels of physical activity by the use of online measurement system should be considered. Second, individualized adaptive technologies for selecting optimal physical activities for the elderly may be better fit to individuals' current status of physical activity. Conclusion: The current status of physical activity in community-dwelling frail elderly can be monitored by online assessment systems. Through the innovative measurement system, elderly may assess his/her physical activity status overtime, select optimal physical activities matching the status, and create the elderly's own adaptive wellness programs that match to the status while residing in his/her community.

Exploratory Study of Factors Affecting Continuity of Cancer Care: Iranian Women's Perceptions

  • Fouladi, Nasrin;Ali-Mohammadi, Hossein;Pourfarzi, Farhad;Homaunfar, Nasrin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권1호
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    • pp.133-137
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    • 2014
  • Background: Today, breast cancer is increasing in nearly all societies. Currently, cancers are the third leading cause of death in Iran after cardiovascular diseases and accidents. Of the cancers, breast cancer is spreading particularly rapidly among Iranian women. Negative effects of discontinuation of care on patient survival have been well documented. Inhibiting or facilitating factors affecting continuity of care at different stages of the patient care continuum should be identified. Materials and Methods: The current study implemented a qualitative method that provided tools to examine factors in detail. This study was conducted on 22 women, undergoing surgery and chemotherapy after being diagnosed with breast cancer. Content analysis was the technique adopted. Results: The effective factors in continuity of care from the patients' perception, based on the participant statements, were classified into three categories of evaluation of symptoms, psychological reactions, and care triggers with several subcategories. Conclusions: According to the outcomes of the current study, it can be noted that, the patient experiences can be brought into use by health-care professionals and assist them in providing patient sand their families with adequate consulting services. It can also provide an opportunity for making interventions tailored to the community culture, and closer adherence of patients to the prescribed treatments.

근골격센터의 프로그램 및 공간구성에 관한 연구 (A Study on the Medical Program and Spatial Organization for Musculoskeletal Center)

  • 윤우용;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권4호
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    • pp.49-58
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    • 2015
  • Purpose: Musculoskeletal disorder is one of diseases with high medical demand over-65 populations. Considering complex, chronic property of diseases, it is important for patients to provide specialized medical service. The musculoskeletal center is one of the most essential facility type in order to give adequate care to the patient suffering from musculoskeletal diseases. Methods: Statistical analysis relating to the component ratio of patients for the demand for medical care. Literature analysis for characteristic of the musculoskeletal diseases. The Status Survey of health care facilities operating in the musculoskeletal center. Results: It is necessary for the musculoskeletal center to be composed of four major areas such as consultation, examination, diagnosis, intervention for continuity of care. For continuum of care, it is essential to build medical environment integrated with each level of care such as consultant, examination, diagnosis procedure. Implications: This study is a basic research for design of musculoskeletal center, and need to be followed by further study using various perspectives and methods.

의사결정분석을 이용한 우리나라 노인의 요양시설서비스 이용 결정요인에 관한 연구 (A Study on Factors of Elderly Residential Care Service Utilization for using Decision Tree Regression)

  • 임정기
    • 한국사회복지학
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    • 제60권3호
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    • pp.129-150
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    • 2008
  • 본 연구는 노인장기요양보험제도 2차 시범사업 결과를 바탕으로 우리나라 노인의 요양시설 서비스 이용에 영향을 미치는 요인을 탐색해 보고자 하였다. 이론적 모형으로는 앤더선과 뉴만(Andersen and Newman)의 행동주의 모델을 토대로 하여 영향요인을 구분하였으며, 연구방법은 의사결정분석을 이용하였다. 분석결과 서비스 이용에 가장 큰 영향을 미치는 것은 대상 노인의 서비스 이용의향이었으며, 이러한 선행요인 다음 중요한 요인으로 자원 요인(수발자 있음 및 동거가족 여부)으로 나타났다. 욕구요인으로는 인지장애가 있는 경우, 치매로 인한 문제행동이 있는 경우, 기본적 일상생활수행능력에 있어 완전도움을 받아야 하는 경우로 나타났다. 이러한 분석결과는 앤더슨과 뉴만의 행동주의 이론의 과정을 그대로 보여주고 있음을 알 수 있는데, 즉 선행요인과 자원요인에 의해 서비스 이용형태가 달라지며, 이러한 선행요인과 자원요인은 욕구요인과 결합하여 실제 서비스 이용에 영향을 주는 것으로 나타났다. 이를 통해 본 연구는 시설 서비스 이용 대상자의 욕구요인을 정확히 파악하여 이에 적절한 서비스 내용을 구축하고 지역사회 내 시설서비스 이용노인을 선별하는데 기초 자료를 제공하는데 기여하고자 한다.

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환경 방사능 처리기술에서의 Compton suppression 및 Unsuppression system을 이용한 토양시료의 MDA 측정 (Measurement of MDA of Soil Samples Using Unsuppression System and Compton Suppression of Environmental Radioactivity in Processing Technology)

  • 강수만;임인철;이재승;장은성;이미현;권경태;김창태
    • 한국방사선학회논문지
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    • 제8권6호
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    • pp.293-299
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    • 2014
  • Compton suppression 장치는 Compton 산란 반응을 이용하여, 스펙트럼의 Compton continuum 부분을 억제함으로써 Compton continuum 영역 내에서의 감마선 피크들의 분석을 보다 명확하게 할 수 있게 해주는 장치이다. 표층토양 시료에서 검출된 인공 방사능인 $^{137}Cs$과 자연 방사능인 $^{40}K$핵종의 방사능 농도 값들에 대한 방사능 계수치가 백그라운드를 상회하는 측정값이 발생되거나, 불필요한 방해피크나 비해석 대상 피크에 대하여 검출된 표준선원의 방사능 농도 값들의 실측치에 대한 background를 비억제 스펙트럼(Compton Unsuppression)과 억제 스펙트럼(Compton suppression)을 적용시켜 측정 에너지에 대한 교정을 알고자 점선원인 $^{137}Cs$을 거리별에 따라 측정하여, 몬테칼로 시뮬레이션과 비교 분석함으로서 효율적인 검출 능력을 얻고자 함이며, Compton 억제 인자를 보면 거리가 멀어짐에 따라 CSF 값이 클수록 더 많은 Compton suppression가 이루어졌음을 알 수 있고, $^{137}Cs$을 이용한 컴프턴 비억제 모드와 억제모드로 측정된 스펙트럼에서 컴프턴 연속에 의한 백그라운드가 감소함을 알 수 있었다.

Modelling inelastic hinges using CDM for nonlinear analysis of reinforced concrete frame structures

  • Rajasankar, J.;Iyer, Nagesh R.;Prasad, A. Meher
    • Computers and Concrete
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    • 제6권4호
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    • pp.319-341
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    • 2009
  • A new formulation based on lumped plasticity and inelastic hinges is presented in this paper for nonlinear analysis of Reinforced Concrete (RC) frame structures. Inelastic hinge behaviour is described using the principles of Continuum Damage Mechanics (CDM). Member formulation contains provisions to model stiffness degradation due to cracking of concrete and yielding of reinforcing steel. Depending on its nature, cracking is classified as concentrated or distributed. Concentrated cracking is accounted through a damage variable and its growth is defined based on strain energy principles. Presence of distributed flexural cracks in a member is taken care of by modelling it as non-prismatic. Plasticity theory supported by effective stress concept of CDM is applied to describe the post-yield response. Nonlinear quasi-static analysis is carried out on a RC column and a wide two-storey RC frame to verify the formulation. The column is subjected to constant axial load and monotonic lateral load while the frame is subjected to only lateral load. Computed results are compared with those due to experiments or other numerical methods to validate the performance of the formulation and also to highlight the contribution of distributed cracking on global response.