• Title/Summary/Keyword: Disability in ADL

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The relationship between disability and clinical outcomes in maintenance dialysis patients

  • Kang, Seok Hui;Do, Jun Young;Kim, Jun Chul
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.127-135
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    • 2021
  • Background: Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients. Methods: This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization. Results: The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend). Conclusion: Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

A Study on the Change of ADL in the Elderly Disability Women after the Self Rehabilitation Exercise at Bedside (신체 장애 여성노인들의 침상 재활운동 후 일상생활수행능력 변화 연구)

  • Kim, Soo-Min
    • The Korean Journal of Health Service Management
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    • v.5 no.4
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    • pp.127-136
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    • 2011
  • The improving in physical activity of Disability elder is the most important and effective way of prevent and treatment. Especially, It improves ADL(Activities Daily of Living) by decreasing restrictive function and dependence. This study was researched on change by comparing before and after about ADL of Women elders who were instructed self rehabilitation exercise in bedside and have been take that. The whole subjects are 92 persons. Elders aged 65 to 69 are 32 persons. elders aged 70 to 74 are 22 persons 38 persons are over the age of 75. This study shows that the whole subjects have been improved ADL. especially, "Take a bath" in detail items of ADL comes to the most improvement rate. Next, "Sit to stand on the bed and transfer" comes to the second highest rate. According to findings upon the age group. "Take a bath" is also the highest improvement rate. Elders aged 60 to 65 show "Sit to stand on the bed and transfer" is the second highest rate of improvement" and elders aged 70 to 74 show that "control urine" is the second highest rate of improvement. and elders over the age of 75 shows that "sit to stand on the bed and transfer" is the second highest rate of improvement. This study have some problems on having possibilities of results because hospitalized persons have answered imperfect statement and being compare progressed for short term with rehabilitation exercise. so, There are some causes that is early to be generalized.

Changes in Pain, Fatigue, Perceived Health Status, Joint Stiffness, Disability in ADL, and Depression after Tai Chi for Arthritis Program (관절염 환자를 위한 타이치 프로그램 적용 후 통증, 피로, 인지된 건강상태, 관절뻣뻣함, 일상활동장애, 우울의 변화)

  • Lee, Kyung-Sook;So, Ae-Young;Choi, Jung-Sook;Lee, Eun-Hee;Yoo, Bo-BI
    • Journal of muscle and joint health
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    • v.15 no.1
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    • pp.53-61
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    • 2008
  • Purpose: The purpose of this study was to observe the changes of the pain, fatigue, perceived health status, disability in ADL, and depression after Tai Chi for arthritis. Method: The subjects were 19 osteoarthritis women enrolled at one primary health care post. They have agreed to participate in this study, and participated in the 12-week Tai Chi program from Dec. 2006 to Mar. 2007, and all the measurement processes in right after, 2 months later, and 4 months later after Tai Chi program. The measurement tools of this study were all self-reported questionnaires such as Numerical Rating Scale (0-100) for pain, fatigue, and perceived health status, Korean-WOMAC (Western Ontario and McMaster University Osteoarthritis) Index for joint stiffness, Korean Health Assessment Questionnaire, and CES-Depression scale. Results: The repeated measure ANOVA revealed the significant differences on pain among the right after, 2 months later, and 4 months later the program. Especially 2 months later after program, pain was significantly increased than right after by t-test. There were no significant differences on fatigue, perceived health status, disability in ADL, and depression. Conclusion: Pain was increased after Tai Chi for arthritis program, but fatigue, perceived health status, disability in ADL, and depression were not changed until 4 months after Tai Chi program.

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Predictors of Health-related Quality of Life (HRQoL) in the Home-dwelling Disabled Persons by using EQ-5D: Results from the 3rd Korea National Health and Nutritional Examination Survey 2005 (재가 장애인의 EQ-5D를 활용한 건강관련 삶의 질의 영향 요인: 국민건강영양조사 제 3기(2005) 자료를 토대로)

  • Chung, Sung-Suk;Joung, Kyoung-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.291-302
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    • 2010
  • Purpose: This study was a secondary data analysis aimed at identifying the predictors of health-related quality of life (HRQoL) of the home-dwelling disabled person by using EQ-5D which is a standardized instrument used as a measure of health outcome. Methods: Data were drawn from the 3rd Korea National Health and Nutritional Examination Survey conducted by the Ministry of Health and Welfare (MOHW). Subjects were 1,021 home-dwelling disabled persons over 19 years of age. Data were analyzed by using descriptive statistics, t-test, Pearson's correlation, one-way ANOVA, Scheff$\acute{e}$ test, and Stepwise multiple regression. Results: HRQoL (Health Related Quality of Life) is differentiated within age, genders, educational level, employment status, economic status, types and grades of disability, health problems associated with limited mobility, and the limited duration of time. HRQoL is correlated with age, number of cohabiters, educational level, grades of disability, activities of daily living (ADL), and instrumental ADL (IADL). HRQoL is significantly associated with ADL, health problems in connection with limited mobility, employment status, types of disability, marital status, grades of disability, and the limited duration of time. These factors explained 63.7% of variance in HRQoL. Conclusion: HRQoL among the disabled is related to their characteristics, ADL, and IADL. For this reason, it is necessary to develop health programs to promote those variables required to improve HRQoL.

A Study of Activities do Daily Living Performance on Arthritic Elderly Patients (노인의 퇴행성 슬관절염과 일상생활 수행력에 관한 연구)

  • Park Rae-Joon;Park Young-Han
    • The Journal of Korean Physical Therapy
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    • v.14 no.4
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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.

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Quality of Life and the Related Factors in Patients with Dizziness (어지럼 환자의 삶의 질 관련요인)

  • Lee, Hyun-Jung;ChoiKwon, S-Mi
    • Journal of Korean Academy of Nursing
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    • v.39 no.5
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    • pp.751-758
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    • 2009
  • Purpose: The purpose of this study was to investigate the Quality of Life (QOL) and related factors in the patients with dizziness. Methods: The data were collected between March and June 2008 for 200 individuals who agreed to participate in the study. Uncertainty (Uncertainty in illness scale), anxiety, depression (Hospital anxiety & depression scale) and Vestibular disability activities of daily living (Vestibular disability-activities of daily living [ADL] scale) as well as QOL (Dizziness Handicap Inventory) were measured. Results: The mean QOL score was 37.5 (${\pm}23.0$). Monthly income, etiology of, frequency of, and total duration of dizziness were the significant factors related to QOL in these patients. Having had a fall, anxiety, depression, uncertainty and vestibular disability in daily living were also significant factors influencing QOL. In multiple regression analysis, anxiety, vestibular disability-ADL, falls, total duration of symptoms, uncertainty, and etiology of dizziness explained 41% of variance of QOL. Conclusion: The level of QOL in our patients was moderate as compared to those in previous studies. Anxiety and vestibular disability were the most important factors predicting low QOL. Use of nursing intervention programs designed to relieve these factors should also result in improving the QOL in the patients with dizziness.

Effect of Elastic Band Based Resistance Exercise on Upper Limbs Strength and ADL of Frail Elders (탄성밴드를 이용한 저항운동이 허약 노인의 상지 근력 및 ADL에 미치는 효과 연구)

  • Kim, Soo-Min
    • The Korean Journal of Health Service Management
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    • v.6 no.2
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    • pp.71-80
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    • 2012
  • The purposes of this study were to effect the upper extremities strength and ADL with upper extremities in frail elders. This study comparison upper extremities strength to pre-exercise and post-exercise and ADL with upper extremities. 30 elders who was in C silver hospital in Busan after resistance exercise during 12 weeks using elastic band, It was confirmed that improvement upper extremities strength and ADL with upper extremities after resistance exercise. As a result of study about effect of elastic band based resistance exercise on ADL of frail elders, it seems to have good effect on over all items(eating, dressing, bathing, make-up, go to a rest room). Therefore, it is necessary to find method about rehabilitation exercise for frail or partial disability elders.

Activities of Daily Living and Instrumental Activities of Daily Living of Elderlies in Chollabuk-Do Area (일부 전북지역 노인들의 일상생활동작능력과 수단적 일상생활동작능력)

  • Lee, Ki-Nam;Jeung, Jae-Yeal;Jahng, Doo-Sub;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.65-83
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    • 2000
  • To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

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Gender Difference in the Prevalence of Disabilities in Activities of Daily Living among the Korean Elderly (한국 노인의 성별 일상생활활동 장애율)

  • Kang, Eunjeong
    • 한국노년학
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    • v.27 no.2
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    • pp.409-425
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    • 2007
  • The purposes of this study were to compare the disability prevalence and its related factors between men and women. The data used for the analysis was the National Health and Nutrition Survey, 2005, and the instrument of measuring disability was the K-ADL which had been developed by Won(2002). Chi-square test and multivariate logistic regression were used to test the gender difference. In the bivariate analyses, women had more disabilities than men among the entire elderly and the young elderly. However, there was not gender difference of disability among the old elderly. After controlling for age and other factors related to disability, no gender differences in the prevalence of disability were found. However, in the same analyses for the individual activities of daily living, men had more disabilities than women for all the activities except bathing and incontinence control. In conclusion, women's higher prevalence of disability in the univariate and bivariate analyses were spurious, because it was disappeared when other related factors to disability were controled for and women's disability became lower than men for some activities of daily living.

A Study on Activities of Daily Living and Perceived Health Status of Disabled Persons at Home in Rural Areas (농촌 지역 재가 장애인의 일상생활 수행능력과 지각된 건강 상태)

  • Kim, Hyeon-Ok;Joung, Kyoung-Hwa
    • Research in Community and Public Health Nursing
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    • v.18 no.2
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    • pp.252-265
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    • 2007
  • Purpose: This study was attempted to provide basic data required to develop community-base rehabilitation program for disabled persons at home by investigating their characteristics. ADL, and perceived health status. Method: The subjects were 146 disabled persons at home in rural areas. Data were collected from January 22 to January 31, 2004. Data were analyzed using frequencies, percentages, means, standard deviations, minimums, maximums, $\chi^2$-test, Fisher's exact test, t-test, one-way ANOVA, Scheffe test, Contingency coefficient, Pearson's correlation, Stepwise multiple regression. Results: The average score of ADL was $5.51{\pm}1.92$: sphincter control $(5.85{\pm}2.10)$, communication $(5.66{\pm}2.02)$, transfers $(5.67{\pm}2.21)$, self care $(5.44{\pm}2.05)$, social cognition $(5.33{\pm}2.08)$, and locomotion $(4.85{\pm}2.32)$. This means that the respondents were in the state of dependence. The main items requiring others' help were 'bathing' (57.7%) and 'going up and down stairs' (51.1%) ADL was significantly different according to age, sender, occupation, medical fee payer, type, severity and duration of disability, BMI, and alcohol drinking. Among the respondents, 82.8% perceived that their health status was bad. Main factors influencing the perceived health status of disability were age and ADL$(R^2=.343)$. Conclusion: Perception of health status among the disabled is related to their characteristics and ADL, so it is necessary to develop community-base rehabilitation programs in order to improve ADL and the perception of health status.

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