Purpose: The aim of this study was to identify demographic, clinical, physical, and psychosocial factors affecting discharge delay in lumbar spinal surgery patients who were treated according to a critical pathway. Methods: A sample of 170 patients with lumbar spinal surgery agreed to participate in the study, between April 1, 2014 and August 30, 2015. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test, ANCOVA, and logistic regression analysis using SPSS 22.0 program. Results: Approximately fifty-nine percent of the participants was delayed discharge. On logistic regression analysis, female gender (OR=2.63, 95% CI=1.40~4.94), age (OR=1.03, 95% CI=1.01~1.05), spondylolisthesis (OR=4.49, 95% CI=1.90~10.61), and spinal fusion operation (OR=4.14, 95% CI=1.89~9.05) were significant factors predicting discharge delay of the participants. However, discharge delay was not related with pain, physical function, depression, or family support. Conclusion: An analysis of discharge delay may assist in evaluating and revising critical pathway for optimal care. In addition, nurses need to understand the factors affecting discharge delay of the given population who were treated according to a critical pathway.
Purpose: Lifestyle intervention (LSI) provides basic recommendations that improve the quality of life and health of patients with minor disabilities. The LSI intervention strategies are associated with active living, healthy weight, healthy eating, and emotional stability. These intervention strategies can change an unhealthy lifestyle to a healthy lifestyle and provide important health care information. Main issue: This study focused on a new LSI-based knee rehabilitation protocol and proved the effect of exercise prescription on the knee. The clinical significance of this study demonstrated that continuous rehabilitation, effective rehabilitation, and recurrence prevention can be achieved by prescribing the appropriate exercise for patients after discharge. Therefore, practical lifestyle medicine knowledge and information are provided by the home-based rehabilitation self-exercise program with the new LSI-based knee rehabilitation protocol. Conclusions: The LSI-based protocol can improve and maintain health conditions and knee function. With the aim of improving self-care abilities, this program is expected to make significant contributions recurrence prevention, reduced mortality, and improved quality of life, physical function, and fitness.
Purpose: This study was conducted to examine the effects of tailored supportive education on physical, psychological status and quality of life in the patients with congestive heart failure (CHF) who had not participated previously in cardiac rehabilitation program. Methods: This study was used a non-equivalent control pre-post design, conducted on 64 CHF patients under medical treatment in a hospital. The experimental group (n=31) received the tailored supportive educational program (once 1~2 days before discharge and 6 times after discharge through outpatient visits or telephone contact: once every week for the first 4 weeks after discharge and once every 2 weeks for the remaining 4 weeks). The control group (n=33) received a traditional discharge education. Data were analyzed using descriptive statistics, ${\chi}^2$-test, Fisher's exact test, t-test and repeated measure ANOVA using the SPSS/ WIN 18.0 program. Results: Participants in the experimental group showed the significantly increased scores of the quality of life (F=16.01, p<.001), and the significantly decreased scores of physical function (F=7.27, p=.009), depression (F=8.25, p=.006) and anxiety (F=4.11, p=.047), when compared to those of the control group. Conclusion: The findings indicated tailored supportive education was an effective intervention care in physical, emotional status and quality of life for CHF patients.
The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.
A dominant opening in a windward wall, which generates large internal pressures in a building, is a critical structural design criterion. The internal pressure fluctuations are a function of the dominant opening area size, internal volume size and external pressure at the opening. In addition, many buildings have background leakage, which can attenuate internal pressure fluctuations. This study examines internal pressure in buildings for a range of dominant opening areas, internal volume sizes and background porosities. The effects of background porosity are incorporated into the governing equation. The ratio of the background leakage area $A_L$ to dominant opening area $A_W$ is presented in a non-dimensional format through a parameter, ${\phi}_6-A_L/A_W$. Background porosity was found to attenuate the internal pressure fluctuations when ${\phi}_6$ is larger than 0.2. The dominant opening discharge coefficient, ${\kappa}$ was estimated to lie between 0.05 to 0.40 and the effective background porosity discharge coefficient ${\kappa}^{\prime}_L$, was estimated to be between 0.05 to 0.50.
The PT program provides relief to most patients with symptom of TOS. So the purpose of our study is to evaluate a effects of PT program in patients with TOS. PT program included orthopaedic manual therapy with the aim of restoring the function of the upper thoracic aperture is to be recommended, and long-term following is advisable. 1. Mean treatment duration was over an 11.4 day(range 4~24). 2. At the follow-up evaluation, 88.1% of the patients were satisfied with the effects of their therapy. 3. 73% of the patients returened to work after PT and 88% of the patients carried through the recommendations given at discharge during follow up. 4. Normalized grip strength and Tinel' sign predicted patient satisfaction(p< .001) and return to work(p< .001). 5. Return to work was more often successful if the work was sedentary rather than heavy (p< .05).
Objective: The purpose of this study was to investigate the effect of exercise therapy and bedside ergometer exercise on muscle strength, function level, and quality of life of persons in intensive care. Design: Randomized Controlled Trial Methods: Sixteen patients in the ICU were randomly assigned to either the exercise group (n=8) or the bedside cycle ergometer group (n=8). Activities in the ICU exercise group (rolling, sitting at the edge of the bed, transfer from sitting to standing, standing balance training, ambulation) and bedside cycle ergometer group were performed 5 times a week for 30 minutes during the ICU admission period. Medical Research Council (MRC) and Functional Status Scale-Intensive Care Unit (FSS-ICU) parameters were assessed at the time of admission to the ICU, and reevaluation was assessed on the day of ICU discharge. The Short Form-36 (SF-36) was assessed at the time of discharge from the ICU. Results: MRC and FSS-ICU were significantly increased before and after intervention in both the experimental and control groups (p<0.05). There was a significant difference between MRC and FSS-ICU in the comparison of the changes before and after the intervention (p<0.05). SF-36 was compared between groups after intervention and there was a significant difference between the experimental and the control group (p<0.05). Conclusions: Muscle strength and functional levels improved after intervention in both the experimental and control groups. The ICU exercise group was more effective than the bedside cycle ergometer group to improve muscle strength, functional level, and quality of life performance of persons in the ICU.
Purpose: This study examined the effects of a positioning education program through the brochure or oral explanations for the parents of premature infants with a brain lesion and investigated the satisfaction level of physical therapy of parents of premature infants with a brain lesion. Methods: Forty parents of premature infants with a brain lesion participated in this study. The recruited premature infants were randomized into groups A (n=20) and B (n=20) for the purpose of the positioning education method through brochure or oral explanations. The level of satisfaction and recognition for the positioning education program was investigated by the parents of 12 month old infants. The gross motor function, measure-88, was examined at three months, six months, nine months, and twelve months of the corrected age. Results: No significant differences in the recognition of the position education program, level of satisfaction of the environment, and the attitude of the therapist were noted (p>0.05). Significantly high levels of satisfaction with the program of group B given the brochure were noted. The gross motor function measure-88 was also similar in both groups (p<0.05). Conclusion: This study suggests that the parents were satisfied with the positioning education program of the brochure. The differences in educational methods did not affect the development of premature infants.
PURPOSE: The purpose of this paper is to provide a review of physiotherapy intervention for patients with COVID-19 during their hospital admission and post-discharge. METHODS: The recommendations and guidelines of physiotherapy management, medical management, and general information of the WHO, Australian Physiotherapist, European Respiratory Society, British Thoracic Society, and American Thoracic Society were reviewed. RESULTS: This paper contains general information on COVID-19, including medical management, and the importance of physiotherapy approaches including an assessment of the patients' function, such as the 6-minute walking test, five sit to stand or sit to stand for one minute to measure their function as their recovery journey. The patients' quality of life, anxiety, and depression should be considered. Physiotherapy management should be based on an assessment of the patient's presenting impairments, including inclusion and exclusion of physiotherapy intervention. The paper also approaches step by step with the disease progress, from an intensive care unit, the general ward in the acute phase, through to the rehabilitation ward if needed, and post-discharge as an outpatient.. CONCLUSION: The paper has a limitation due to the unknown factor of the natural history of COVID-19. Depending on the patients' recovery journey and the rehabilitation needed, any physiotherapy interventions should focus on what the patients' need on their journey to recovery, e.g., pulmonary, cardiac, neurological, and general rehabilitation. In addition, applying personal protection equipment for treating physiotherapists is a mandatory requirement because this protects from the transmission of COVID-19.
The purpose of this study was to identify the differences in pulmonary functioning after respiratory exercise with IPPB (Intermittent Positive Pressure Breather) in patients with progressive muscular dystrophy (PMD). The subjects were 46 patients with PMD who were admitted to the Rehabilitation Medicine Department of Youngdong Severance Hospital. The subjects were assigned into one of 2 groups. The control group received comprehensive treatments such as ROM exercise, deep breathing exercise, moist hot packs, and ultrasound twice a day while admitted at the Rehabilitation Medicine Department. Unlike the control group, the subjects at the experimental group received respiratory exercise treatment with IPPB. The subjects were admitted for 10~19 days, and the average length of hospital stay was 12.2 days. Pulmonary functioning was evaluated at admission and discharge by SENSOR MEDICS. The data were analyzed by a paired t-test and a independent t-test. The results were as follows: 1) The change of each parameter of pulmonary function tests were significantly improved in all groups after respiratory exercise treatment during admission (p<0.05). 2) By comparing the change of each parameter of pulmonary function tests between the experimental group and control group, the parameters of vital capacity (VC), forced vital capacity, forced vital capacity predicted (FVCP) and forced expiratory volume in 1 second (FEV1) were significantly improved in the experimental group which had received the pulmonary exercise treatment with IPPB (p<0.05). In conclusion, this study suggests that the pulmonary exercise treatments with IPPB facilitated improvement in the pulmonary functioning for the PMD patients during their hospital stay.
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