• Title/Summary/Keyword: Disability in ADL

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A Study on Social Integration of Person With Disabilities based on Independent Living Paradigm : Life Span (자립생활 패러다임에 따른 장애인의 사회통합에 관한 연구 : 생애주기를 중심으로)

  • Park, Soo-Kyung
    • Korean Journal of Social Welfare
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    • v.58 no.1
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    • pp.237-264
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    • 2006
  • The purpose of this study is to examine the level of social integration of the person with physical disabilities based on independent living paradigm according to life span and to find factors affecting social integration and therefore to make policy implications for a better rehabilitation system. The data was obtained through telephone interviews with physically disabled residing in the city of Seoul and the suburb area of the city. The final sample consists of 591 respondents. The data was analyzed through frequency, oneway anova, pearson's correlation analysis, and multiple regression. In this study, social integration based on independent living paradigm was divided into separate but related dimensions: autonomy of activity daily living, accessibility, economic level, degree of social support satisfaction, consumer control, psychological empowerment. The major findings of this study were as follows: First, the levels of six dimensions of social integration based on independent living paradigm were very different and especially the level of dimensions such as degree of social support satisfaction and consumer control were lower than other dimensions of social integration. Second, each level of social integration by life span was very different. Finally, the factors affecting social integration were socio-psychological traits such as social support, rehabilitation services, self esteem and acceptance of disability as well as the attribution to disability. The current findings suggest that improving nay only ADL or accessibility but also consumer control or social support should be considered by professional and policy makers. And differentiated intervention and policy according to life span necessary to policy makers and field practitioners.

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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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Changes in Activities of Daily Living of Children with Spastic Cerebral Palsy According to Gross Motor Function Classification System After One Year of Physical and Occupational Therapy (물리 및 작업치료 1년 후 대동작 기능분류체계에 따른 경직성 뇌성마비 아동의 일상생활동작 변화)

  • Lee, Kwon-Woo;Kim, Won-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.431-440
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    • 2019
  • This study was conducted to investigate changes in activities of daily living (ADLs) according to the Gross Motor Function Classification System (GMFCS) after one year of physical and occupational therapy and to compare the responsiveness of ADL tools. A total of 48 children with spastic cerebral palsy participated in the study. The GMFCS, Functional Independence Measure for Children (WeeFIM), and Pediatric Evaluation of Disability Inventory (PEDI) were measured. The results showed that the GMFCS was significantly correlated with the PEDI (p<0.05), while there was a significant difference in the change of ADLs measured by the PEDI, but not the WeeFIM. There was a significant difference in the changes in ADLs according to the GMFCS, and the change in ADLs in the high functional level group was significantly higher than in the low functional level group (p<0.05). After physical and occupational therapy, the degree of improvement of ADLs varied according to the GMFCS, but seemed to be improved in a clinically meaningfully way. The PEDI is sensitive to changes in ADLs, so it may be used widely in clinical practice.

Need Survey of Home Modification on Outpatient with Stroke and Spinal Cord Injury in Rehabilitation Center (재활치료를 받는 뇌졸중과 척추손상 외래환자들의 주거환경개선에 대한 요구도 조사)

  • Lim, Kyung-Min;Lee, Yu-Na
    • The Journal of the Korea Contents Association
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    • v.13 no.8
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    • pp.324-333
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    • 2013
  • The purpose of this study was to investigate the need of home modification for outpatient with stroke and spinal cord injury. The subjects of this study were 54 outpatients who have experience in rehabilitation therapy at hospitals in Seoul and Gyeonggi-do. A questionnaire was distributed and collected form January 2th to February 4th, 2012. Descriptive statistics and $x^2$-test were used to analyze data. There were statistically significant difference in stairs of access, in width of front door, in bathroom, space of room according diagnosis. There were statistically significant difference in light of sensor, tissue holder and socket cover in bathroom for the comparison of demands for home modification by living type. There were statistically significant difference in width and threshold of front door, tissue holder and towel bar, nonslip floor in bathroom, space and table, chair of kitchen, space and threshold of porch, light for the comparison of demands for home modification according score of MBI. Based on the results of the survey, needs of home modification is different according disability level, diagnosis, living type, ADL performance. The results of this study show a need for the further occupational therapy of home modification and supporting policies in home modification.

The Relationship Between Self-Concept and Self-Care Activities of the Cerebral Palsied Adolescents (뇌성마비 청소년의 자아개념과 자가간호수행의 관계)

  • Hong, Hee-Sook;Lee, Myung-Hwa
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.31-45
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    • 2001
  • The purpose of this study was to investigate the relationship between self-concept and self-care activities of the cerebral palsied adolescents and to gain the baseline data for development of effective rehabilitation nursing intervention program of the cerebral palsied adolescents. The design of this study was a descriptive correlational study. The subjects of the study were 160 cerebral palsied adolescents attending at special schools located in Seoul and Kyonggi and rehabilitation centers located in Seoul, Kyonggi and Kyongnam province. The data was collected from May 20 to July 20, 2000. The instrument used for this study were the self-concept scale(50items 4point scale) and self-care activities scale(29items 4point scale). Self-Concept Scale had developed by Fitt(1965), which was standardized by Chung(1968) and modified by Kim(1984). Self-Care Activities Scale developed by the researcher through out the consulting of expert and pilot study on the basis of ADL check list developed by Kang(1984) and LDSQ-3(Lambeth Disability Screening Questionnair-3) developed by Na et al. (1995). The data was analyzed by the SPSS/PC+program using frequency, percentage, mean, standard deviation, t-test, ANOVA & Scheffe test and Pearson's correlation coefficient. The results of this study were as follows; 1. The mean score of self-concept was $138.55{\pm}17.20$(range: 50-100), which the item mean score was $2.77{\pm}0.34$(range: 1-4). The score of subarea of the self-concept was the highest score in family self ($3.01{\pm}0.54$) and the lowest score in physical self ($2.52{\pm}0.42$). 2. The mean score of self-care activities was $95.25{\pm}21.69$ (range: 29-116), which the item mean score was $3.28{\pm}0.75$ (range: 1-4). The score of subarea of the self-care activities was the highest score in feeding($3.75{\pm}0.59$) and the lowest score in walking($2.64{\pm}1.21$). 3. There were statistically significant difference in the score of self-concept according to the age (F=3.24, P=.04), the grads (F=4.36, P=.01), and types of cerebral palsy (F=2.42, P=.03). 4. There were statistically significant difference in the score of self-care activities according to the age (F=8.29, P=.00), the grads (F=16.05, P=.00), types of living place (F=6.46, P=.00), types of cerebral palsy (F=48.92, P=.00), whether or not receiving a rehabilitation therapy (t=-3.64, P=.00), whether or not receiving a vocational training (t=2.14, P=.03), and whether or not using a device (t=-7.42, P=.00). 5. There was not significant correlation between self-concept and self-care activities (r=.081, P=.311).

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Influential Factors on Rehabilitation Exercise Practice in Elderly Lmited Activities of Daily-Living: An Analysis based on the Theory of Planned Behavior (일상생활수행 제한 노인들의 재활운동행위의 실천에 따른 영향요인 분석(계획된 행위이론을 적용하여))

  • Kim, Soo-Min;Park, Jae-Yong;Han, Chang-Hyun
    • The Journal of the Korea Contents Association
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    • v.10 no.3
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    • pp.271-281
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    • 2010
  • Background: This research has been carried out to analyze presupposition factors which influence factors on Rehabilitation Exercise practice in Elderly limited Activities of Daily-Living an Anlaysis based on Theory of Planned Behavior to support to induce Rehabilitation Exercise behavior. Method: From the geriatric hospitals in Pusan and Kyungnam, 316 elderly who has ADL Disability participated in the study. We did 1st questionnaire investigation. We provided them 4 weeks of Rehabilitation Exercise training, and 2 weeks later we collected 2nd questionnaire sheet to confirm their Rehabilitation Exercise behavior practice and analysed. Results: In this research relative influence to behavioral intention for Rehabilitation Exercise headed by attitude toward the behavior(.61), perceived behavior control(-.56) and subjective norm(.27)these results were slightly different from other research, in case of perceived behavior control was low but on attitude toward the behavior it showed high in results. It's older have strong subjectivities and has not change their mind, the old's behavioral intention is expressed as an attitude toward the behavior. Rehabilitation Exercise Practice of Elder should prioritize to have the health belief which is positive, As a result it will be regarded to expect the maximum effect.

A Correlation between Stress and Activities of Daily Living related to the Ego-defense Mechanism in Stroke patients (뇌졸중 환자의 자아방어기제에 따른 스트레스와 일상생활활동 수행능력과의 상관관계)

  • Ryu, Sung-Hyun;Choi, Hyeon;Jeon, Ji-Hye;Choi, Su-Ji
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.1-9
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    • 2015
  • Objective : This study is to investigate the correlation of Ego-degense mechanism, stress and activities of daily living of stroke patients. Methods : The study was carried out from March 14, 2014 to May 15, 2015. A survey was conducted at a university hospital and three rehabilitation hospitals located in Daegu and Busan. For statistical analysis, frequency analysis, independent sample t-test, and Pearson correlation coefficient were used in this study. Results : As a result of the mature Ego-defense mechanism grop was more stressful than immature Ego-defense mechanism group(p<.05), mechanism group also showed better performance in activities of daily living activity(p<.05). Conclusion : The higher stress in stroke patients related to the disability to perform activities of daily living. Psychosocial rehabilitation for factors such as stress as well as physical function in stroke patients in the rehabilitation of stroke patients by using the Ego-defense will have a significant impact on an individual's personality or lifestyle.

The Effect of Reminiscence with Audio-Visual Stimulation on Senile Dementia (치매노인에게 시청각 자극을 병행한 회상요법의 적용효과)

  • 김남초;유양숙;한숙원
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.98-109
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    • 2000
  • The purpose of this study was to identify the effect on improvement of the Activity of Daily Living (ADL) and decrease the cognitive function and agitation behaviors by reminiscence with audio-visual stimulation for senile dementia. The quasi-experimental design was used in this study. Subjects were 26 with mild senile dementia who were cared for at a Day Care Center for Dementia in Seoul. The data were collected from March to July, 1999. Subjects were divided into three groups : Control Igroup with 10 subjects, reminiscence group(Control II group with 8 subjects), and reminiscence with audio-visual stimulation group(experimental group with 8 subjects). The Control I group got routine care as usual. Control II group participated in reminiscence sessions for one hour a day, five times a week , for a period of 4 weeks. The experimental group participated in reminiscence with audio-visual stimulation sessions for one hour a day, five times a week, for a period of 4 weeks. Instruments of this study were color photography with sound that was developed through an open questionnaire about events, objects, humans in action and animals that 100 Korean elderly over 60 would like to memorize. This was referred from the Sensory Stimuli Package by Namazi and Haynes(1994). The effects of treatment was evaluated through MMSE-K by Kwon & Park(1989). Also the Brief Cognitive Rating Scale(BCRS) by Reisberg et al(1983) for the cognitive function, through Agitation Inventory by Cohen- Mansfield and Colleague(1989) for behavioral response and through the Rapid Disability Rating Scale-2(RDRS-2) by Linn & Linn(1982) for the activity of daily living respectively. Data analysis was done using SPSS for $\chi$2- test, ANOVA, repeated measures ANOVA. The results were as follows : 1. Reminiscence with audio-visual stimulation did not improve cognitive function for senile dementia, but significantly improved verbal expression, the subscale of cognitive function. 2. Reminiscence with audio-visual stimulation reduced agitation behavior of experimental group significantly, but there was no significant difference between groups. 3. Reminiscence with audio-visual stimulation did not significantly effect the activity of daily living after treatment. In conclusion, it was shown that the reminiscence with audio-visual stimulation was an effective therapy to improve verbal expression and to reduce agitation behaviors of senile dementia. Further research with more indepth approach is needed, considering characteristic and level individualized for each senile dementia.

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Factors Related to Depressive Symptoms Among the Elderly in Urban and Rural Areas (일부 지역사회 노인들의 우울수준과 관련요인)

  • Lee, Jong-Cheon;Park, Jung-Ah;Bae, Nam-Kyou;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.33 no.2
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    • pp.204-220
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    • 2008
  • Objectives: This study was performed to determine the levels of depression symptoms among the community elderlies and to reveal its related factors, specifically aimed at revealing psycho-social factors such as social support net-work, sense of self-esteem, state anxiety, interpersonal behavior trait and locus of control. Methods: The interviews were performed during the period from April 1st to June 30th, 2007 to the 790 elderlies in urban and rural areas. Results: The mean scores of depression (CES-D) among all subjects were 16.65±10.97(urban: 18.81±10.31, rural: 14.49±11.20) and they were higher in urban than rural. The level of depression symptoms was influenced by the variables of educational level, with or without spouse, bear for living expenses, sense of satisfaction in daily life. As for health related behaviors, they were influenced by the variables of with or without regular exercise. As for health status, they were influenced by the subjective health status, with or without disability of body, visual acuity, hearing ability, ability of food mastication, urinary incontinence, with or without help in activity of daily living (ADL) and instrumental activity of daily living (IADL). As for social support net-work and social activities, they were influenced by number of offspring, frequency of offspring contents, frequency of going out and activity of hobbies. As for psycho-social factors, they were influenced by sense of self-esteem, state anxiety and social support, especially, the level of depression symptoms was higher influenced by the variables of psycho-social factors than other variables. Conclusions: Lower of the level of depression symptoms among the community elderlies would require development and application of programs to keep under management psycho-social factors as well as looking for ways to promoting the present health status.

Research on the Need Assessment Tool for the Korean Elderly at Home Focused on their Desires Based (한국 재가노인의 욕구중심 사정도구 개발에 관한 연구)

  • Kirn, Young sook;Jung, Kook in;Park, So rah
    • 한국노년학
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    • v.27 no.2
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    • pp.459-472
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    • 2007
  • This research has its purpose of developing a tool to assess the needs of the Korean elderly at home population and to provide adequate services by evaluating their physical, psychological, and socio-environmental aspects. This developed tool is composed of two hundred questions and has the advantage of combined physical, psychological and social environmental situation assessment of the elderly at home. The tool also contains not only the objective view of the professionals, but also the subjective appeals of the elderly at home population so that it can reflect their substantial desires. The assessment tool was developed over 21 months from July, 2004 to March, 2006 and this period can be divided into three different stages. In the first stage, collecting of questions for the desire-focused assessment of the elderly by literature investigation and researching foreign source materials was carried out, and this ultimately developed assessment tool was applied to the long-term care insurance pilot project in the second stage. In this process, we revised some insufficiencies of this tool after we applied to elderly of 250 from the pilot project and other 200 elderly from this research team. For the last stage, the tool was completed by using inquiries of the focused group and the group of professionals to ensure its reliability and validity. In the process of developing the tool, the total of 200 questions under 13 subcategories was selected. The 13 subcategories are basic information, subjective appeals, information of the main helper, use of services, house environment, condition of health, condition of rehabilitation, daily living(ADL, IADL, defecation, assistance), social maintenance, behavioral disability, medical health, living habits, and strength. This tool is on the purpose to assess thoroughly the desires that the elderly at home population has and to provide the best service they need.