• 제목/요약/키워드: Disability and Health

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한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황 (THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA)

  • 권도윤;남옥형;김미선;최성철;김광철;최재영;이효설
    • 대한장애인치과학회지
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    • 제14권1호
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    • pp.11-16
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    • 2018
  • In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

섬유조직염 환자의 가족지지, 지식, 자기효능감, 증후 및 신체활동장애 간의 관계분석 (Relational Analysis between Family support, Knowledge, Self-efficacy, Syndrome and Physical disability of Fibromyalgia Patients)

  • 한상숙;강현숙
    • 근관절건강학회지
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    • 제5권2호
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    • pp.191-205
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    • 1998
  • This study was conducted to identify the relations between the factors influencing syndrome and physical disability of fibromyalgia patients. The subjects of this study were 125 outpatients selected at H. Rheumatism clinic from February to July in 1997, The Collected data were analyzed by Frequency, Pearson correlation using SPSS Windows and Path analysis using LISREL 7.16. The results were as follows. 1. General characteristics of subjects About 2/3 of subjects were over 40years of age and most of them were graduated from high school. The Christian were over a half (54.0%) of subjects. 2. Correlation between Family support, knowledge, Self-efficacy, Syndrome and physical disability. As knowledge was positively related to self-efficacy(r=.306), the family support was positively related to self-efficacy(r=.217), and family support was negatively to syndrome. Self-efficacy showed negative relation with syndrome and Physical disability. Syndrome as physical disability represent positive relation. Therefore all hypotheses were supported. 3. Causal relations between research variables. Family support influenced on syndrome, as syndrome on physical activity, as well as knowledge on self-efficacy & physical disability. The model also showed a good fit to the data[$X^2$=1.21 df=1(p=.546), GFI=.996, AGFI=.971, RMSR=.023]. 4. Correlation between symptoms of Fibromyalyia. Having analyzed the relations between tender point, pain, stiffness, functional disturbance, sleep disturbance, depression, fatigue, anxiety, the results were as follows ; All relations show statistically positive correlation, which means close relationship between symptoms, except between pain and depression, pain and anxiety. As a result, symptoms of Fibromyalgia had close relation. Therefore, these were common, rather than individual symptoms. This syndrome influenced on physical disability, and self-efficacy on the both, as knowledge on self-efficacy. In conclusion, to improve syndrome relief and physical disability of fibromyalgia, nursing interventions such as education, self-efficacy increasing stratagy, and family counseling are needed.

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장애에 따른 상실생존년수를 활용한 대기중 총먼지와 아황산가스가 심혈관계질환에 미치는 영향 측정 (Quantifying the Burden of cardiovascular Disease Attributable to Total Suspended Particulate and Sulfur Dioxide Using Years Lived with Disability)

  • 하범만;강종원;권호장;윤석준
    • Journal of Preventive Medicine and Public Health
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    • 제35권2호
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    • pp.92-98
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    • 2002
  • Objective : To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide ($SO_2$) in Korea using the YLD (years lived with disability) measurement. Methods : Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and $SO_2$ levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and $SO_2$ was estimated using the number of years that the patient lived with a disability. Results : The VLD of the CHF due to the TSP and $SO_2$ was attributed to the TSP (94.4 person-year) and $SO_2$ levels (35.0 person-year). The YLD of the ME due to the TSP and $SO_2$ was attributed to the TSP (148.4 person-year) and $SO_2$ levels(27.6 person-year). Conclusion : The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.

여성 류마티스 관절염 환자의 피로 예측 모형 (Prediction Model of Fatigue in Women with Rheumatoid Arthritis)

  • 이경숙;이은옥
    • 근관절건강학회지
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    • 제8권1호
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    • pp.27-50
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    • 2001
  • Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

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유착성 관절낭염 환자의 상지 기능에 대한 ICF Tool을 적용한 PNF 중재전략의 증례보고 (A Case Report of PNF Strategy Applied ICF Tool on Upper Extremity Function for Patient Adhesive Capsulitis)

  • 강태우;김태윤
    • 대한물리의학회지
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    • 제12권4호
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    • pp.19-28
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    • 2017
  • PURPOSE: The purpose of this study was to describe the Proprioceptive Neuromuscular Facilitation (PNF) Intervention strategy applied International Classification of Functioning, Disability and Health (ICF) Tool about strength, range of motion, scapular stability, pain and function of shoulder for patients with adhesive capsulitis. METHODS: The data was collected by patient with adhesive capsulitis. The patient was a 50-year-old male diagnosed with right shoulder with adhesive capsulitis. We applied the PNF Intervention strategy applied ICF Tool to patient with adhesive capsulitis. PNF interventions were consisting of such as combination of isotonic and stabilizing reversal technique and various positions. PNF interventions were applied, such as those aiming at decreasing pain and disability and increasing range of motion and function for the four weeks. Parameters of result were collected for strength, range of motion, scapular stability, pain and function of shoulder using the hand held dynamometer, goniometer, lateral scapula slide test, and shoulder pain and disability index, respectively. RESULTS: Clinical benefits were observed the patient with adhesive capsulitis for strength, range of motion, scapular stability, pain, and function of shoulder. The patient with adhesive capsulitis improved strength, range of motion, scapular stability, pain, and function of shoulder. CONCLUSION: Patient reported improved strength, range of motion, scapular stability, pain, and function of shoulder after intervention.

Immediate Effects of Moving Myofascial Decompression Therapy for Young Adults with Nonspecific Neck Pain

  • Min, Kayoon;Kim, Namwoo;Lee, Yongwoo
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.116-123
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    • 2021
  • Objective: The purpose of this study was to investigate the effects of myofascial decompressiontherapy using moving suction on body temperature, pain, neck disability index, and cervical rotation for young adult with nonspecific neck pain. Design: Two-group pretest-posttest design. Methods: The subjects were randomly assigned 22 patients with chronic cervical pain who met the study conditions to the experimental group (n=11) and the control group (n=11). In the experimental group, the myofascial decompressiontherapy (MDT) was performed for 10 minutes using moving suction withnegative 15 mmHg pressure from the insertion to the origin of the upper trapezius muscle, while the control group without negative pressure. In order to investigate the effects of the intervention, an infrared thermometer, a visual analogue scale, neck disability index, and goniometer were used. Results: As a result of comparing the pre- and post- changes in each group according to the intervention, skin temperature, pain, neck disability index, and cervical rotation in both the experimental and control groups were significantly improved (p<0.05). Comparison of pre- and post- changes between the experimental and control groups showed significant differences for pain and cervical rotation (p<0.05), but no significant difference was found in the body temperature and neck disability index. Conclusions: Based on the results, MDT using moving suction was effective in reducing pain and increasing of cervical rotation for young adult with nonspecific neck pain.

A Review of Domestic Research Trends Related to the International Classification of Functioning, Disability and Health (ICF): 2015-2020

  • Song, Ju-Min
    • 대한물리의학회지
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    • 제16권3호
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    • pp.65-80
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    • 2021
  • PURPOSE: This study was conducted as a literature review to analyze the research trends related to the International Classification of Functioning, Disability and Health (ICF) in Korea from 2015 to 2020. METHODS: Precedent studies were searched with the search term "ICF" or "international classification of functioning, disability and health" from the databases of RISS, KISS, DBpia, and Pubmed. The inclusion criteria are that the studies have been carried out in Korea from 2015 to 2020 using ICF by researchers consisting of one or more Koreans and have been peer-reviewed. RESULTS: Of the total 269 studies, 107 that met the inclusion criteria were analyzed. It was found that these studies were published at a similar frequency each year. The most common area of expertise was identified as the clinical area (n = 67), followed by special education (n = 21) and social welfare (n = 13). The study subject groups were mostly patients (n = 39), disabled people (n = 25), and related experts (n = 13). The most common research topic was functioning evaluation (n = 49) and followed by a literature review (n = 29), and the most frequently used components in all the areas of expertise were activity and participation (n = 98), body function and structure (n = 73), and environmental factors (n = 61). CONCLUSION: For the past six years, domestic ICF-related research has been conducted in a wider range of expertise areas on more subdivised subject groups. Continuous research, development of standardized curricula and contents, and development of coding tools are considered to be important in vitalizing the use of the ICF.

Mapping Items of Functioning Questionnaires into the International Classification of Functioning, Disability and Health: Low Back Pain

  • Lee, Hae-Jung;Song, Ju-Min
    • The Journal of Korean Physical Therapy
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    • 제28권5호
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    • pp.321-327
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    • 2016
  • Purpose: The purpose was to link items of questionnaires that measure functioning and disability of persons with Low Back Pain (LBP) into the International Classification of Functioning, Disability and Health (ICF). Methods: The Oswestry Disability Index (ODI), Roland and Morris Disability Questionnaire (RM), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short Form-36 health survey (SF-36) were evaluated to map items of those questionnaires into the ICF categories. The linking rule was employed and linking was performed independently by 10 health professionals. One-hundred and two patients with LBP were recruited from 19 medical institutes to this study for a field test to examine relations between the scale and its linked ICF category set. Pearson correlation coefficient was used to analyze their relationships. Results: Walking was only found to be one-to-one linking between the scale and the ICF. Sixty questions in FABQ were to be linked to 9 of ICF categories. Ten and 14 ICF categories were able to be linked to RM and ODI respectively. It was found that majority of items from ODI and RM scale had similar concept and linked to the same ICF category. SF-36 had only 15 categories of the ICF linked. Strong relationship was observed between measurement scales and linked ICF code sets (r=0.79, r=0.65, r=0.47, and r=-0.31 for ODI, RM, FABQ and SF-36 respectively). Conclusion: It was found that commonly used clinical tools for LBP may be linked to ICF. The study results may suggest that clinical data can be standardized to communicate between related professionals.

수중운동이 여성 관절염환자의 통증과 피로, 체력, 일상활동장애 및 심리적 변수에 미치는 효과 (The Effects of an Aquatic Exercise Program on Pain, Fatigue, Physical Fitness, Disability in ADL, and Psychological Variables in Women with Arthritis)

  • 장경오
    • 지역사회간호학회지
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    • 제20권1호
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    • pp.87-95
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    • 2009
  • Purpose: The purpose of this study was to examine the effects of aquatic exercise on pain, fatigue, physical fitness, disability in ADL, and psychological variables in women with arthritis. Methods: With a quasi-experimental design, 46 women who has arthritis were assigned into an experimental group (n=23), or a control group (n=23). Data were analyzed with SPSS/WIN using descriptive statistics, t-test and ANCOVA. Results: The mean age of the subjects was 60.9 years in the experimental group and 59.8 years in the control group. The pretest scores of the outcome variables were similar between the two groups except fatigue and waist flexibility. After controlling fatigue and waist flexibility, the experimental group showed more improvement than the control group in Rt shoulder flexibility score (F=4.36, p=.04), sit-up score (F=32.34, p=.00), and muscle strength score (F=30.78, p=.00). The score of disability in ADL decreased in the experimental group (F=5.49, p=.02). The depression score decreased in the experimental group (F=12.01, p=.00), and self-efficacy was improved more than the other variables(F=8.88, p=.00). Conclusion: Aquatic exercise is likely to be an effective nursing intervention to improve physical fitness, to reduce pain, fatigue, and disability in ADL, and to enhance psychological functions in women with arthritis.

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장애 학생의 학교생활 적응에 영향을 미치는 요인에 관한 연구-학교 및 장애 특성을 중심으로 (Study on the influencing factors on school adjustment of students with disabilities-Focused on school and disability related characteristics)

  • 이은순;윤상용
    • 디지털융복합연구
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    • 제14권10호
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    • pp.455-461
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    • 2016
  • 본 연구는 장애학생의 학교생활적응에 미치는 영향 요인을 분석함으로써 장애 아동 및 청소년들이 학교생활에 잘 적응하도록 돕기 위한 방안을 수립하는 데 필요한 기초자료를 제공하는 것을 목적으로 하고 있다. 이를 위해 보건복지부에서 실시한 2014년 장애인실태조사 원자료를 분석자료로 하여, 초등학교, 중학교, 고등학교에 재학 중인 학생 197명을 대상으로 학교급별, 학교유형, 장애유형, 장애정도, 주관적건강상태, 차별경험 등 학교 및 장애 특성요인이 학교생활 적응에 영향을 미치는 지를 검증하고자 집단 간 평균비교 및 다중회귀분석 등을 실시하였다. 분석결과 학교급별, 학교유형, 장애정도 등이 장애학생의 학교생활 적응에 영향을 미치는 것으로 나타났다. 따라서 장애학생의 학교생활 적응을 돕기 위한 또래지원 프로그램 도입, 특수학급 증설, 보조인력, 제도적 보완 등이 필요하다.