• Journal of Korean Neurosurgical Society
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• 제65권2호
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• pp.173-179
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• 2022

Disabilities can emerge due to traumatic spinal fractures. In terms of sacrococcygeal spine, because of its unique anatomic structure with minimal movement, the possibility for it to have a disability is relatively low. In Korea, unlike most disability criteria, private insurance companies acknowledge angular deformities caused by vertebral fractures as disabilities according to their degree, so there were several cases where patients required compensation, arguing angular deformity caused by sacrococcygeal fracture, which in some cases led to legal conflicts. Except the Act Welfare of Persons with Disabilities which recognizes only severe angular deformity affecting internal organs as disability and the industrial accident disability evaluation which does not recognize coccygeal fracture as disability but rarely recognizes sacral vertebra deformity equivalent to compressive deformation, there is little or no case where angular deformity is recognized as disability. Given the impairment evaluation standards in social insurance, McBride system, American Medical Association (AMA) guides, and newly proposed standards by the Korean Academy of Medical Sciences (KAMS), the most contentious point in the general terms and conditions of private insurance is spinal deformity. To overcome controversy over disability evaluation, the private insurance sector is now applying criteria for axial skeleton to sacrococcygeal vertebrae through revision of standards. Under these circumstances, it is fair to recognize sacrococcygeal fracture as impairment in terms of the pelvis only when the fracture leaves serious deformity and neurological symptoms with clear relevancy. Though it may not be easy to develop accurate disability evaluation standards, improvement is necessary to remove any irrationalities and make the standards as objective as possible.

• 생물정신의학
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• 제15권4호
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• pp.310-315
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• 2008

Objectives : The evaluation of disability after trauma in psychiatry is relatively subjective compared with other departments. A consensus among evaluators could improve reliability of evaluations. We compared disability rate of common psychiatric disorders without definite brain injury depending on their diagnosis from experienced evaluators in Korea. Methods : A written questionnaire was mailed to each evaluator and the reply was analyzed. The questions included disability rate ranges of postconcussional syndrome, PTSD and depression. Other questions related with admission for evaluation, expected duration of treatment, life expectancy and need of supporting person were also asked. Results : Range of disability rate were from $8.6{\pm}4.5%$ to $26.6{\pm}12.8%$ in postconcussional syndrome, from $10.4{\pm}6.8%$ to $36.4{\pm}13.8%$ in PTSD and from $10.0{\pm}4.6%$ to $30.6{\pm}10.3%$ in depressive disorder. There were lots of diversity in expected duration of treatment with psychiatric disability. Decline of life expectancy and need of supporting person were considered at least 50% of disability. Conclusion : There is much diversity in evaluation of psychiatric disabilities with disability rate and expected duration of treatments even among experienced evaluators. A common consensus among experts may increase reliability of psychiatric evaluations after trauma.

• 재활간호학회지
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• 제10권1호
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• pp.45-57
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• 2007

Purpose: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. Method: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. Result: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. Conclusion: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.

• 예술인문사회 융합 멀티미디어 논문지
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• 제7권3호
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• pp.889-899
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• 2017

컴퓨터 및 정보통신 기술의 발전으로 인해 특수 교육 분야에서도 ICT 기술을 접목해 시너지 효과를 얻기 위한 다양한 노력과 기술 개발이 진행되고 있다. 본 논문에서는 특수 교육 분야에서 활용 가능한 ICT 기반의 장애 평가 웹사이트와 모바일 애플리케이션을 설계하고 구현한 다음 이를 특수 교육 현장에서의 필드테스트를 통해 그 효용성을 확인하였다. 개발한 웹사이트는 평가자가 노트북이나 PC를 이용해 평가 대상자의 자폐 행동이나 학습 장애를 평가할 수 있도록 하며, 모바일 애플리케이션은 평가자의 스마트폰이나 태블릿 PC 등 모바일 기기를 이용해 시간과 장소에 구애받지 않고 간편하게 평가가 이루어질 수 있도록 한다. 평가 결과는 서버 데이터베이스에 저장 관리되며, 개발한 웹사이트와 모바일 애플리케이션은 서로 데이터베이스를 공유하므로 쉽게 연동되어 활용 가능하다는 장점이 있다. 본 연구 결과는 특수 교육 현장에서 평가 대상자를 지속적으로 평가하고 관찰하는 데 유용하게 사용될 수 있으리라 기대한다.

• 대한정형외과학회지
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• 제55권5호
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• pp.366-373
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• 2020

장애의 개념은 명확하게 정의하기는 매우 어려운 일로 알려져 있고, 전 세계적으로 실제 장애가 평가되는 방식은 추정되는 장애의 개념과는 괴리가 있다. 무엇이 적절한 장애평가인지 제시하기는 어려운데 이는 장애의 종류와 정도를 잘 반영해야 하고, 사회가 감당할 수 있는 평가자의 시간과 비용으로 일정 수준의 일관성, 신뢰도와 정당성이 담보되어야 하기 때문이다. 장애평가에서 매우 세세한 평가 규격을 사용하면 재량권이 제한되고, 이는 일관성과 신뢰도를 높이지만 개별적인 차이나 예외적인 상황을 무시하는 결과가 발생한다. 장애평가법 중에 손상접근 방법은 전 세계적으로 가장 오래되고 널리 사용되는 방법으로 현재 우리나라에서 사용되고 있는 대부분의 장애평가 방법이 여기에 속한다. 맥브라이드법은 비교적 많은 시간을 쓰지 않고 신체장애율과 노동능력 상실률을 함께 구할 수 있으며, 현재 법원에서 노동력 상실 평가에 사용하고 있는 중요한 방법이다. 여러 오류와 논란이 있음이 잘 알려져 있어 이의 수정이 요구되지만 현재로서 우리나라의 장애평가 방법에 대한 개선안은 또 다른 새로운 평가 기준을 제시하기 보다는 현재 가장 널리 사용되고 있는 맥브라이드 평가 방법을 보완하여 사용하는 것이다. 본 종설에서는 장애의 개념과 장애평가 방법에 대하여 설명하고, 장애평가 방법의 종류를 소개하면서 맥브라이드의 노동능력상실 평가법이 아직도 유용하게 사용될 수 있는 당위성에 대하여 알아보고자 한다.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.293-296
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• 2009

Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.

• The Korean Journal of Pain
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• 제20권1호
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• pp.1-7
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• 2007

Pain is one of the most common causes of disability and work loss. However, patients with chronic pain have not been regarded as impaired persons in the Republic of Korea because of a lack of objective findings in those patients and difficulties in validating their genuine suffering and quantitative evaluation of pain. Here, the difficulties in the evaluation of impairment in chronic pain patients are discussed. In addition, guidelines for rating impairment in chronic pain patients, which are under development by the Korean Academy of Medical Sciences, are introduced.

• Journal of Preventive Medicine and Public Health
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• 제36권2호
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• pp.163-170
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• 2003

Objectives : This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. Methods : To develop the valuation protocol, the Global Burden of Disease(GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. Results : The disability weights were valued in a two step panel sfudy. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. Conclusions : It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies, This would provide a rational basis for an international comparative study of disability weights.

• 컴퓨터교육학회논문지
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• 제9권2호
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• pp.57-67
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• 2006

본 연구는 발달장애 영유아를 위한 교육과정중심 진단, 중재, 평가의 연계 체계를 웹상에서 전문가 시스템으로 설계하였다. 이를 위하여 교육과정중심 진단 평가와 웹기반 전문가 시스템에 관한 선행연구와 특수교육에서 공학적 활용에 관한 연구를 분석한 후, 웹기반 전문가 시스템의 전체 구조와 하위 시스템을 체계적이고 구체적으로 설계하였다. 발달장애 영유아를 위한 웹기반 전문가 시스템 설계에서는 정보분석, 최적화, 자료수집, 자료분석, 의사결정으로 중재의 연결 구조를 강조하였다.

• The Korean Journal of Pain
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• 제31권3호
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• pp.199-205
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• 2018

Background: Sleep disturbance and depression are becoming more recognized as important symptoms among individuals with chronic low back pain. This study evaluated the effect of stabilization exercise on pain-related disability, sleep disturbance and the psychological status of patients with non-specific chronic low back pain (NSCLBP). Methods: A total of 26 patients (M/F = 17/9) with NSCLBP with a mean age of $50.0{\pm}15.5$ took part in this study. Participants were recruited from selected hospitals in Lagos state. Ethical approval was sought and obtained from the health research and ethics committee of Lagos University Teaching Hospital Idi-araba, Lagos, Nigeria. Participants performed stabilization exercise for eight weeks consecutively and were assessed for pain-related disability, anxiety, depression, and sleep disturbance using the pain-disability index, hospital anxiety and depression scale, and the insomnia severity index at baseline, the 4th week, and the 8th week, postintervention. Results: The participants studied recorded significant reduction in pain-related disability (P = 0.001). There was also improvement in the sleep quality (P = 0.001), depression level (P = 0.001), and anxiety level (P = 0.001), post intervention. Conclusions: This study revealed that stabilization exercise is very useful in the management of sleep disturbance, pain-related disability, depression, and anxiety in NSCLBP patients.