• Title/Summary/Keyword: Disability in ADL

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구조화된 재활교육이 뇌졸중환자 가족의 스트레스에 미치는 영향 (A Study of the Effect of Structured Rehabilitation Education on the Stress of the Family with Stroke Patients)

  • 김병은;이정민;이향련
    • 동서간호학연구지
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    • 제1권1호
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    • pp.22-39
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    • 1997
  • Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

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성인이 된 장애자녀를 돌보는 노인부모의 부양부담감 (The Burden of Aged Parents Caring for Adult Children with Disabilities)

  • 석민현;김은혜
    • 지역사회간호학회지
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    • 제21권4호
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    • pp.439-447
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    • 2010
  • Purpose: This study was to describe the burden of aged parents caring for adult children with disabilities and related factors. Methods: The subjects were 123 caregivers aged over 65 who were caring for 18-year-old or older children with disabilities. The research tool of this study was a structured questionnaire on family burden. Data were collected from June 3 to 25, 2010, and analyzed by Cronbach's alpha, mean, standard deviation, t-test, and ANOVA using SAS 9.2 program. Results: The major findings of this study were as follows. Elderly parents caring for adult children with disabilities perceived a moderate level of burden. The burden from concern over their children's future was highest, and economic and physical burdens were higher when the parents were younger. Burden was significantly different according to parents' characteristics such as gender, perceived health status, disease, the costs of caring for disabled children, and children's characteristics such as disability rating, health status, and ADL. Conclusion: In order to reduce the burden of elderly parents caring for adult children with disabilities, we need to improve their health status and assess comprehensive policies.

장애인 부모를 가진 비장애 성인자녀의 성숙 변화 과정에 관한 연구 - 원가족 환경 경험을 중심으로 - (The Effects of Family-of-origin Environment and Change of during Their Grow-up Period of Adult Offsprings with Disabled Parents)

  • 정현정
    • 보건의료산업학회지
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    • 제6권1호
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    • pp.231-245
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    • 2012
  • This study was focused on experience of adult offsprings with disabled parents, and thereby on the evaluation of their family-of-origin environment. Adult offsprings's experience and understanding of the evolution in terms of subjects were explored. This study reviewed the effects of the family-of-origin environment and the analysis of data based on qualititative research depending on Saiki Greig Hill theory. The summary of this is as follows; perception and attitudes about disables parents tended to strengthen the steps 'process of recognition about disabled parents', 'process of escape about disabled parents',' precess of integration about disabled parents'. The alternative programs of the strengthen the steps 'process of integration about disabled parents' should be developed government policy support according to age group, ADL(activity of daily life) support according to disability status and emotional support with a focused on health family support center, public health center, religion meeting. This study was to provided basic material needed to do further research on this issue by identifying the effects of family-of-origin environment on adult offsprings with disabled parents.

가정방문물리치료가 재가장애인의 일상생활동작과 기능에 미치는 영향 (Effects of Home Visiting Physical Therapy on Activites of Daily Living and Function in Disabled Persons Living at Home)

  • 박승규;지혜영;허재원
    • The Journal of Korean Physical Therapy
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    • 제23권2호
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    • pp.61-68
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    • 2011
  • Purpose: The purpose of this study was to provide basic data for the effectiveness and the necessity of home visiting physical therapy through examining performance ability and functional changes in daily life activities by investigating the life of disabled persons living at home. Methods: After selecting 100 people with physical disabilities greater than level 3 and brain damage related disabilities living in Youngam-Gun, we conducted mobility tests according to a Modified Bathel Index (MBI), the Berg Balance Scale (BBS), and floor and bed movements? for Activities of Daily Living evaluation. We did this before the experiment and after doing home visiting physical therapy for 90 minutes at a time, once a week for 6 months Results: 1) Persons who live in a bed are higher than those who live in a floor. There was a significant difference between persons who live in a floor and those who live in a bed in the change in MBI and BBS scores after home visiting physical therapy. 2) Those with a musculoskeletal disorder had a significantly different change in MBI and BBS according to the type of disease and kind of disability. Those with neuropathy had a significantly different change in MBI. Those with physical disabilities showed a significant difference in MBI and BBS. Conclusion: A home visiting physical therapist can cause an improved performance ability and lead to the ability of disabled persons living at home to carry out activities of daily livingin a large part and the study for brain lesion disabilities except physical disabilities and stroke which occupy large proportion of disabled persons should be done.

농촌지역 노인들의 주관적 행복감과 이에 관련하는 요인 (Subjective Well-Being and It's Related Factors in Korean Rural Elderly)

  • 이성국;카이 이치로
    • 농촌의학ㆍ지역보건
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    • 제20권2호
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    • pp.121-131
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    • 1995
  • This study aims 1) To explicate the multidimensional structure of a widely used measure of subjective well-being, the Philadelphia Geriatric Center(PGC) Morale Scale is used to measure health in elderly populations and 2) To examine the relationship between the socioeconomic status and related variables, health and physical disability and subjective well-being in elderly populations. The selection of subjects was determined through a survey of 672 rural dwelling elderly persons(269 males and 403 females) aged 60 years and over. The respondents were interviewed by 18 trained health workers using the questionnaire from July 4 to July 9 in 1994. The subjects were surveyed again during the period from August 1 to August 6 in 1994 to conform the questionnaire's reliability. Subjective well-being was evaluated using the Revised Questionnaire of the Philadelphia Geriatric Center(PGC) Moral Scale(17 items, Lawton, 1975). The results are as follows : 1) The item scores were intercorrelated and subjected to a principal component analysis. A rotated three-factor solution was done, accounting for 40.9% of the total variance. Thus, the PGC morale Scale can be derived from three stable factors : Factor 1 was explained "Lonely Dissatisfaction(7 items)", Factor 2 was explained "Agitation (5 items)", Factor 3 was explained "Attitude Towards Own Aging (5 items)". Further, these factors have a high degree of internal consistency, as determined by Cronbach's alpha : 0.7852. 2) The total mean score of PGC Morale Scale was 8.73. Sex, Age, Education, Current disease, Family type, Economic status, ADL, IADL were significantly difference in mean scores of PGC morale scale. 3) In the results of stepwise multiple regression analysis of subjective well-being. the most contributing factors were economic status, IADL, current disease, family type, sex and the R square was 0.23.

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뇌졸중 환자를 위한 일상생활활동 평가도구에 관한 체계적 고찰 (A Systematic Review of Assessment Tools of Activities of Daily Living for Stroke Patients)

  • 강재원;박지혁
    • 재활치료과학
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    • 제6권2호
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    • pp.11-28
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    • 2017
  • 목적: 본 연구는 뇌졸중 환자를 위한 일상생활활동 평가도구에 관해 체계적 고찰함으로써 임상 및 연구에서 자료로 활용되고자 하였다. 연구방법: 2001년부터 2016년까지 학회지에 게재된 논문을 검색하기 위하여 Pubmed, Embase, Cochrane, NDSL 데이터베이스를 사용하여"stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement"를 검색하여 체계적 고찰을 하였다. 평가도구의 종류와 사용빈도를 분석한 후 이에 대한 경향을 파악하였다. 또한 국제 기능 장애 건강 분류(International Classification of Functioning, Disability and Health; ICF) 모델의 분류 기준에 맞추어 활동과 참여에 대한 평가도구를 분류하였다. 결과: 총 111개의 논문이 최종적으로 분석되었으며, 30개의 평가도구가 확인되었다. 최근 들어 뇌졸중 환자를 대상으로 한 연구 게재편수가 증가함에 따라 평가도구의 종류와 사용빈도가 증가하였다. 가장 많이 사용되는 평가도구는 기능적 독립성 측정(Functional Independence Measure; FIM), 바델 지수(Barthel Index; BI)와 캐나다작업수행측정(Canadian Occupational Performance Measure; COPM)이었다. ICF 모델의 분류 기준에 따라 분석한 결과 대부분의 도구는 활동에 대한 평가도구로 참여에 대한 평가도구 수는 매우 적었다. 결론: 본 연구는 뇌졸중 환자의 일상생활활동 수행능력을 측정하기 위해 사용된 평가도구를 체계적으로 고찰하였다. 연구 결과 FIM, BI와 같은 특정한 도구가 많이 사용되었다. 앞으로는 평가도구의 특성에 맞춰 적절한 평가가 이루어 질 수 있도록 다양한 평가도구를 사용한 연구가 진행되어 근거기반의 작업치료를 뒷받침 해 주어야 한다. 또한 ICF 모델의 분류 기준 중 참여에 대한 평가도구의 개발이 이루어져야 할 것이다.

뇌성마비 성인의 근골격계와 기능 실태 (Musculoskeletal and Functional Status of Adults with Cerebral Palsy)

  • Yoon Myung-ok;Kim Chung-sun
    • The Journal of Korean Physical Therapy
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    • 제17권1호
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    • pp.43-68
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    • 2005
  • The purpose of this study was to report the physical status of adult with cerebral palsy who live in local community areas including Seoul, Busan, Daegu in Republic of Korea at 2004. 202-individuals with cerebral palsy(140 male, 62 female; mean age 31.9 years; range 19 to 64 years) were surveyed. Measures included a 29-item self-reported health status measure focusing on musculoskeletal status and functional performances. Adult cerebral palsy required continuous management for musculoskeletal and ambulatory function through therapeutic approach. This survey is restricted to population who had cared in welfare center for cerebral palsy in local community, so it needs to investigate home-residual adults with cerebral palsy and the population in rural community. The results were as follows: 1. Participants reported that they had a limitation of a daily of life activity due to musculoskeletal pain($43\%$), there was significant differences between a limitation of a daily of life activity and the decreased ambulatory function(p<.05). 2. Thirty six point six percentile of participants had the decreased ADL function, it was significant related with the impaired body location(p<.05) 3. Thirty nine point one percentile of participants who can independently gait had the decreased ambulatory function, it was significant differences with the usage of ambulatory assistive devices(p<.05). 4. There was significant differences ambulatory function both the body region with impairment and a grade of disability(p<.05). 5. Sixteen point three percentile of participants could not ambulate any more, there was significant differences between a age and a point of time for non-ambulation(p<.05). 6. There was significant differences between ambulatory function and physical activity(p<.05).

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Effects of Percutaneous Sacroplasty on Pain and Mobility in Sacral Insufficiency Fracture

  • Choi, Kyung-Chul;Shin, Seung-Ho;Lee, Dong Chan;Shim, Hyeong-Ki;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.60-66
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    • 2017
  • Objective : Sacral insufficiency fracture (SIF) contributes to severe low back pain. Prolonged immobilization resulting from SIF can cause significant complications in the elderly. Sacroplasty, a treatment similar to vertebroplasty, has recently been introduced for providing pain relief in SIF. The purpose of this study is to investigate the clinical short-term effects of percutaneous sacroplasty on pain and mobility in SIF. Methods : This study is conducted prospectively with data collection. Sixteen patients (3 men and 13 women) with a mean age of 77.5 years (58 to 91) underwent sacroplasty. Patients reported visual analogue scale (VAS; 0-10) and Oswestry disability index (ODI; 0-100%) scores. VAS and ODI scores were collected preoperatively and again at one day, one month, and three months postoperatively. Questionnaires measuring six activities of daily living (ADLs) including ambulating, performing housework, dressing, bathing, transferring from chair, and transferring from bed were collected. Ability to perform ADLs were reported preoperatively and again at three months postoperatively. Results : The mean preoperative VAS score ($mean{\pm}SD$) of $7.5{\pm}0.8$ was significantly reduced to $4.1{\pm}1.6$, $3.3{\pm}1.0$, and $3.2{\pm}1.2$ postoperatively at one day, one month, and three months, respectively (p<0.01). The mean ODI score (%) also significantly improved from $59{\pm}14$ preoperatively to $15.5{\pm}8.2$ postoperatively at one month and $14.8{\pm}8.8$ at three months (p<0.01). All ADL scores significantly improved at three months postoperatively (p<0.01). Conclusion : Percutaneous sacroplasty alleviates pain quickly and improves mobility and quality of life in patients treated for SIF.

교정 운동과 TECAR 치료가 전방머리자세를 가진 환자의 목정렬과 통증에 미치는 영향 (The Effect of Corrective Exercise and TECAR therapy on neck alignments and pain in Forward Head Posture Patients)

  • 박시은;이형렬;박신준
    • 디지털융복합연구
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    • 제16권11호
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    • pp.543-551
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    • 2018
  • 본 연구는 교정 운동이 전방머리자세 환자의 목뼈 정렬, 압력통증 역치, 통증에 미치는 영향에 대해 알아보았다. 대상자는 목 부위의 통증을 주로 호소하는 환자 중 전방머리자세로 판정되는 30명을 대상으로 연구를 실시하였다. 중재방법으로는 연구군은 등뼈 폄 운동, 네발기기 자세에서 뒤쪽락킹, 그리고 능동 목뼈 돌림 운동과 TECAR치료를 융합하였으며, 대조군은 등뼈 및 목뼈 교정운동만을 적용하였다. 평가는 목 척추 각도, 압력 통증 역치, 목장애지수, 시각적상사척도를 측정하였다. 중재는 2주간 주 6회 실시하였다. 연구결과 두 군 모두 목 척추각도, 압력통증 역치, 목장애 지수, 시각적상사척도에 유의한 차이를 나타내었다. 또한 목 척추각도를 제외한 압력통증역치, 목장애지수, 시각적상사척도에 연구군이 대조군 보다 유의하게 개선되었다. 이러한 결과는 교정 운동과 TECAR 치료를 융합하는 중재 방법이 전방머리자세 환자의 머리 정렬과 통증 및 일상생활능력에 보다 긍정적인 영향을 미친다고 사료된다.

일부 농촌지역 노인들의 요실금 유병률과 관련요인 (Prevalence of Urinary Incontinence and Its Related Factors among the Rural Residing Elderlies)

  • 윤현숙;권인선;배남규;조영채
    • 농촌의학ㆍ지역보건
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    • 제34권1호
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    • pp.76-86
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    • 2009
  • 본 연구는 농촌지역 노인을 대상으로 요실금의 출현빈도를 조사하고 요실금과 관련된 요인을 검토하고자, 2007년 10월 1일부터 12월 31일까지의 기간에 충청남도의 농촌지역에 거주하고 있는 65세 이상 노인 464명을 대상으로 면접조사를 실시하였다. 그 결과 조사대상자의 요실금 경험률을 보면 「매일 실금」이 9.5%, 「가끔 실금」이 35.5% 로 요실금을 경험하고 있는 노인이 45.0%이었다. 성별로는 남자(29.8%)보다 여자(58.5%)에서, 연령이 낮은 군보다 높은 군에서, 교육수준이 높은 군보다 낮은 군에서, 월수입이 높은 군보다 낮은 군에서 요실금 경험률이 높았다. 일상생활습관별 요실금 경험률은 비흡연군보다 흡연군에서, 음주군보다 비음주군에서 유의하게 높았으며, 주관적 건강상태에 따른 요실금 경험률은 건강하다는 군보다 건강하지 않다는 군에서, 건강에 대한 걱정을 하지 않는다는 군보다 한다는 군에서, 신체부자유가 없다는 군보다 있다는 군에서, 건망증이 없다는 군보다 있다는 군에서, ADL과 IADL별로는 도움이 필요 없다는 군보다 도움이 필요하다는 군에서 유의하게 높은 비율이었다. 다변량 로지스틱회귀분석 결과 요실금발생에 영향을 미치는 관련요인으로 성별, 연령, 흡연습관, 건강에 대한 걱정유무, 신체부자유 유무, 건망증 유무, IADL이 유의한 변수로 선정되었다. 이상의 결과를 보면 농촌지역 노인들의 요실금 출현빈도는 남자보다 여자에서, 고연령일수록 높아지는 것을 알 수 있으며, 일상생활습관이나 주관적 및 신체적인 건강상태가 양호하지 않을수록 요실금 출현율이 높게 나타나고 있으므로 이에 따른 노인들의 적절한 건강관리 대책이 요구된다.