• 동국한의학연구소논문집
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• 제8권2호
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• pp.25-46
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• 2000

통증은 환자들로 하여금 내원하게 하는 주된 증상중의 하나로, 치료방법의 선택 및 효과 판정을 위해서는 적절한 평가가 필요하다. 통증은 실험적인 방법과 임상적인 방법에 의해 측정될 수 있는데, 통증의 주관적인 성격상 임상적인 방법이 일반적으로 사용된다. 통증의 임상적측정법은 일차원적측정법과 다차원적측정법으로 대별할 수 있는데, 일차원적 측정법으로는 시각적상사척도(Visual Analogue Scale), 구술적평정척도(Verbal Rating Scale), 수치평정척도(Numerical Rating Scale), 통증표정척도(Pain Faces Scale), 그리고 포커칩 도구(Poker Chip Tool)등이 있고, 다차원적 측정법으로는 McGill 동통질문서(McGill Pain Questionnaire), 다면적인성검사(MMPI), 통증행동척도(Pain Behavior Scale), 통증장애지표(Pain Disability Index), 그리고 통증평정척도(Pain Raing Scale)등이 있다. 일차원적 측정법은 주로 환자의 자가통증평가법에 기초하여 통증의 강도를 측정하는데, 측정방법의 단순함과 신속성으로 인해 급성통증을 평가하는데 주로 사용된다. 다차원적인 측정법은 통증의 주관적, 정신적 그리고 행동적인 면을 측정하는데, 측정방법이 포괄적이고 신뢰성이 있어서 만성통증을 측정하는데 사용된다. 환자의 언어와 인지능력은 정확한 통증을 평가하는데 장애가 되는 주된 요인이다. 통증에 따른 행동반응이나 생체반응은 환자의 통증을 완전히 대변하지 못하지만 이러한 상황에 있어 유용한 통증평가지표가 될 수 있다. 통증평가법을 결정할 때에는 먼저 측정하려고 하는 통증의 성격을 고려하여 어떠한 면을 측정할 것인가를 결정해야하며 아울러 환자의 언어와 인지능력을 고려해야 한다. 적절한 평가법의 선택은 환자의 진단과 치료에 있어 유효한 결론에 이르게 하는 중요한 과정이다.

• 재활복지
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• 제18권4호
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• pp.165-186
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• 2014

본 연구는 체계적 문헌고찰을 통해 통합교육을 받고 있는 초등특수학급 아동의 학교적응에 관한 연구 현황을 국내 등재 학술지를 중심으로 파악하고자 하였다. 데이터베이스 KISS, DBPIA, RISS, Google에서"통합교육, 특수학급, 통합학급, 장애학생, 학교적응, 학교생활, 학교적응척도, 초등학교"를 주요 검색어로 하였으며, 2004년 1월부터 2014년 3월까지 최근 10년간 발표된 논문을 대상으로 하였다. 최종분석대상논문은 35개였으며, 분석결과는 다음과 같다. 첫째, 분석대상논문 35개 중 2004년에서 2007년까지 6개의 논문을 제외한 나머지 29개 논문은 2008년 이후 게재된 것이었다. 둘째, 분석대상 논문들의 연구 대상자는 총 141명이었고, 이중 지적장애가 87명(61.7%)으로 가장 많았고, 그 다음으로는 학습장애가 24명(17.0%)으로 많았다. 셋째, 평가영역은 총 51개로 분석되었으며, 학업성취와 과제수행 13개(25.4%), 수업태도 및 참여행동 12개(23.5%), 문제행동 11개(21.5%)를 평가한 것으로 분석되었다. 장애진단별 분석결과는 지적장애의 평가영역이 10가지로 가장 많았다. 넷째, 평가방법은 총 41개였다. 조작적 정의를 사용한 논문이 23개(56.1%), 평가지 제작 7개(17.1%), 평가도구 사용이 6개(14.6%)순으로 분석되었다.

• 대한감각통합치료학회지
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• 제16권1호
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• pp.25-34
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• 2018

목적 : 본 연구는 학령전기 지적장애아동에게 제공한 그룹감각통합치료가 소근육 기능, 상호작용 및 놀이에 미치는 영향을 알아보고자 한다. 연구방법 : 지적장애 등록을 한 만3~5세 아동 4명을 대상으로 주 1회 90분씩, 총 12회기 실시하였다. 그룹감각통합치료는 평행놀이와 또래놀이 중심의 대근육 활동과 주제에 맞는 미술활동과 감각놀이로 구성하였다. 결과측정은 Erhardt Developmental Prehension Assessment(EDPA)와 또래놀이 상호작용 평점척도(Penn Interactive Peer Play Scale; PIPPS), 놀이다움(The Test of Playfulness; ToP)를 사용하여 대상자의 사전사후 소근육 기능과 상호작용, 놀이를 평가하였다. 측정 결과는 윌콕슨 순위 검정(Wilcoxon matched-pair signed rank test)을 사용하여 소근육 기능과 상호작용, 놀이의 중재 전후로 차이를 비교하여 분석하였다. 결과 : 그룹감각통합치료 후, 소근육 기능은 통계학적으로 유의한 차이를 보이지 않았으나, 상호작용과 놀이에서는 유의한 차이가 있었다(p<.05). 결론 : 그룹감각통합치료는 상호작용과 놀이능력 향상에 유용한 치료적 접근방법이라는 것을 알 수 있었으며, 지속적인 그룹 활동을 통하여 일상생활에서의 다양한 상황에 대한 일반화가 진행되길 기대한다.

• 디지털콘텐츠학회 논문지
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• 제13권3호
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• pp.335-342
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• 2012

이 연구의 목적은 지체 뇌병변장애인의 컴퓨터 접근성 향상을 도모하기 위하여 국내 최초 컴퓨터 접근 평가 시스템을 구현하는 것이다. 본 논문에 소개된 한국판 컴퓨터 접근 평가 시스템인 K-CAAS(Korea-Computer Access Assessment System) 소프트웨어는 클릭, 드래그, 메뉴 선택, 스캔, 스위치로 이루어진 다섯 가지 유형의 평가 기능을 가진다. 각각의 평가 기능 테스트는 사용자 개개인의 특성에 따라 구성 설정을 초급, 중급, 고급, 개별적으로 설정 할 수 있으며, 모든 테스트는 사용자의 수준 설정에 따라 기본 값을 가지고 사용자의 능력과 목표에 따라 난이도를 선택 및 조절할 수 있다. 테스트 시에 사용자의 훈련을 위해 임의로 선택할 수 있고, 사용자의 테스트 결과를 추적할 수 있다. 따라서, K-CAAS는 컴퓨터 접근성 평가, 뿐만 아니라 장애인의 컴퓨터 사용 능력 향상을 위한 재활 프로그램으로 사용이 가능하며 본 시스템을 통하여 향후 장애인의 컴퓨터 접근성이 향상되어 장애인이 스스로 컴퓨터 기능을 능숙하게 사용 할 수 있을 것을 기대한다.

• The Journal of Korean Physical Therapy
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• 제14권4호
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• pp.183-203
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• 2002

To know the effect of index of social ability (ISA) and function of social life (FSL) with activities of daily living (ADL) and instrumental activities of daily living (IADL), we carried out a study on the elderly with osteoarthritis daily living in Daegu city for 4 months, from April to July 2002. The followings were observed: 1. The score of functional disability of knee, ADL and ISA were better at lower age (p < 0.01). 2. The younger they are, the better FSL they have. The lower age group has good FSL (p < 0.01). 3. Weight affects more to the under 49Kg group than 50-59Kg group and 60-69Kg group in functional disability of knee, while it doesn't make much difference for the other groups (p > 0.05) and other assessment index doesn't show any relationship with weight. 4. Regarding relat ionship with height , taller group has better knee functions: it's proved by post hock examination that the over 160cm group has much higher knee function than the other groups (p < 0.05). In case of ADL, the over 160cm group and under 149cm group were better than 150$\∼$159cm group. (p < 0.01) . 5. ISA was also different depending on height . It was proved that FSL was the better for the over 160cm group than for the others as a result of post hock examination (p < 0.05). 6. In regard of how many months have passed since the attack of functional disability of knee, knee joint function was better for the 12mon$\∼$36mon group than for the others and the score of ADL was lower for the 12mon$\∼$36mon group than for the others (p < 0.01). ISA was lower for the 12mon$\∼$36mon group and the under 6mon group than for the other groups (p < 0.01). FSL was lower for the 12mon$\∼$36mon group and the under 6mon group than the other groups. (p < 0.01). 7. Comparing left knee with right one, the problem with left knee has lower score of functional disability in all items (p < 0.01). 8. Considering friction noise, knee joint function was slightly better for non-friction noise-group, but it's not statistically significant though. ADL and ISA were better for non-friction noise-group (p < 0.01), while no statistical significance was found in FSL, 9. Knee joint function was better for the group who doesn't have limitation on range of knee flexion motion (p,0.05) but no other difference was found in other items from this group. 10. Limitation on range of knee flexion motion has no statistical difference in ADL and FSL. However, ISA was better for the non-limitation group (p < 0.05) . 11. Knee joint function score has high correlation with ISA (r=0.812, p < 0.01) and FSL (r=0.732, p < 0.01) , which shows the better knee joint function, the higher the score. 12. ISA and FSL were highly correlated: the better ISA, the better FSL (r=0.893, p < 0.01), while ADL has no correlation with either knee joint function or ISA or FSL.

• 의료법학
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• 제13권2호
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• pp.179-214
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• 2012

There are two opinions on the legal characteristics of damages for non-pecuniary loss, a private sanctions theory and complementary function of damages for non-pecuniary loss, briefly. There is a close connection between the legal characteristics and the function of damages for non-pecuniary loss. The functions of damages for non-pecuniary loss are consist of satisfaction, prevention( sanctions) and complementation. Several cases of medical injury relief reported to Korea Comsumer Agency are categorized as follows, 1) cases of death after having an operation, 2) diagnosed with disability after a medical accident, 3) extended damages happening related to delayed diagnosis, 4) et cetera(a plastic surgery, a treatment with oriental medicine), and the damages for non-pecuniary loss in respect to each cases are examined. In the case of occurring death or disability, Korea Comsumer Agency has set up guidelines for assessment of damages for non-pecuniary loss by classifying into major and collateral violation for a duty of care. Furthermore, the damages for non-pecuniary loss in the case of all sorts of cancers, are assessed in accordance with the degree of responsibility subsequent to dividing cancer into good and poor prognosis. When it comes to a complementary function of damages for non-pecuniary loss in the actual work, it is hard to assess the damages as it is difficult to objectify non-pecuniary loss, such as emotional distress. Though compensation for damages is major legal characteristics of consolation money, preventing a damage(private sanctions) through consolation for a victim or sanctions against an assailant also has great significance. Therefore, it is necessary to approach flexibly for mutual agreement by considering specialty( concrete facts) of individual issue thoroughly. If considering this aging society that limits the possible age for work to 60 years old, it is needed to have a complementary function of consolation money in mind not to make it less meaningful for victims due to small sum of consolation money.

• 대한물리의학회지
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• 제13권3호
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• pp.49-60
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• 2018

PURPOSE: This study was conducted to investigate the intervention effect obtained by applying an ICF tool to improve the dressing in a patient with rotator cuff syndrome to schematize the problems and approaching with PNF to solve the problems. METHODS: The subject of this study was a 44-year-old patient who underwent surgery after complete right rotator cuff tear. To treat his symptoms, the processes of clinical practice were implemented in the order of examination, assessment, diagnosis, prognosis, intervention, and outcome. During examination, patient information was collected using the ICF core set. In the assessment, the problems were schematized, and an ICF assessment sheet was used to identify the interaction of the problems. The diagnosis was made by clearly describing the causal relationship derived from the assessment in ICF terms. To solve the problems, the intervention was given in the order of indirect, direct, and task based on the philosophy of PNF. To evaluate the outcome, the differences before and after the intervention were compared. Additionally, the comparison for the ICF qualifier is presented with the ICF evaluation display. RESULTS: The results of the study showed clinical advantages in shoulder strength, eccentric control, range of motion, scapular stability, and shoulder pain. Overall, our patient with rotator cuff syndrome showed improvement in dressing and undressing activity in response to the PNF strategy. CONCLUSION: Application of the PNF intervention strategy after complete rotator cuff tear would have a positive effect on patient upper extremity function.

• 대한간호학회지
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• 제34권6호
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• pp.1025-1034
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• 2004

Purpose: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs, Method: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. Result: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. Conclusion: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.

• The Korean Journal of Pain
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• 제28권2호
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• pp.75-87
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• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• The Journal of Korean Physical Therapy
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• 제22권3호
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• pp.37-44
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• 2010

Purpose: The purpose of this study was to describe the functional (mobility, self-care, social ability) and health-related quality of life in children with cerebral palsy (CP). Methods: A cross- sectional survey of 202 children with CP, mean age $5.91{\pm}1.57$ years, was carried out using the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), and Child Health Questionnaire (CHQ). Results: The functional assessment of children with CP showed that a more severe GMFCS level was associated with lower functional abilities (p<0.05). The health-related quality of life assessment showed that psychosocial well-being was less impaired than physical well-being. The internal consistency of the three instruments was satisfactory (cronbach's ${\alpha}$>0.80). The three different scales were correlated from moderate to strong (r=0.44 to 0.92). It was also found that mobility, tone distribution, and the parents' education level exerted a significant effect on the quality of life of children with CP (p<0.05). Conclusion: These findings suggest that children with CP have reduced function and quality of life and these are influenced by various factors. However, planning and application of various task-oriented functional interventions to childhood CP may be useful.