• Title/Summary/Keyword: Functional assessment measures

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The Assessment Tools in Palliative Medicine (완화 의학에서의 평가도구)

  • Gwak, Jung-Im;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.177-193
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    • 2009
  • The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

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Time Series Observations of Outcome Variables and the Factors Associated with the Improvement in the Patient Outcomes of Cataract Surgery (백내장수술환자 결과 변수들의 시계열적 관찰과 진료결과 향상에 영향을 주는 요인)

  • Kim, Han-Joong;Park, Eun-Cheol;Choi, Yoon-Jung;Kang, Hyung-Gon
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.175-181
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    • 2001
  • Objectives : To compare the multiple outcomes of patients with cataract surgery at perioperative time,3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). Methods : For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was peformed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was 'conducted at 4 stages' : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. Results : The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 mouths. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom sure were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(09.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. Conclusions : In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.

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An Index of Visual Function in Patients with Cataract - Pilot study - (백내장 환자의 시기능지표 - 사전 연구를 중심으로 -)

  • Kang, Hyung-Gon;Park, Eun-Cheol;Choi, Yoon Jung;Kim, Han Joong;Hong, Young Jai;Cho, Woo Hyun;Sohn, Myongsei;Lim, Seung Jeong
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.128-138
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    • 1998
  • Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

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Factors affecting objective and subjective masticatory ability assessment of Korean elderly people (한국 노인의 객관적·주관적 저작능력 평가에 영향을 미치는 요인)

  • Jung, Hyo-Jung;Min, Yong-Guang;Kim, Hyo-Jung;Lee, Joo-Young;Lee, Eun-Song;Kim, Baek-Il;Ahn, Hyung-Joon
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.216-223
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    • 2018
  • Objectives: The purpose of the study was to investigate factors affecting the assessment of objective and subjective masticatory ability in the elderly, and to evaluate masticatory ability assessment more accurately. Methods: A total of 112 participants were recruited after oral examination in senior citizen welfare facilities. The participants' masticatory ability was evaluated objectively (Mixing ability index; MAI), and subjectively (Key food intake ability; KFIA). Participants' general characteristics and oral health-related variables were also recorded. Based on masticatory ability assessment, participants were classified as either high or low. IBM SPSS Statistics Ver.23.0 was used for all analyses, including descriptive statistics, Chi-square test, Mann-Whitney U test, Spearman rank correlation, and Logistic regression analysis. Results: Higher masticatory ability was positively correlated with higher scores on MAI and KFIA. Additionally, there was a significant positive correlation between MAI and KFIA. When analyzing factors affecting objective and subjective masticatory ability assessments, Functional tooth units (FTUs) were revealed as a related factor. In subjective masticatory ability assessment, oral moisture, difficulty in chewing, and the Geriatric Oral Health Assessment Index (GOHAI) were also influential factors. Conclusions: In order to accurately assess masticatory ability, it is necessary to use both objective and subjective measures. Additionally, to improve the masticatory ability in the elderly, treatment should be provided to improve overall oral health and satisfaction.

A Study on the Measure to Maximize the Effects of Functional Games in Relation to the Changes in Visual and Auditory Stimulations (시각 및 청각 자극 변화에 따른 기능성 게임의 효능 극대화 방안 연구)

  • Shin, Jeong-Hoon
    • Journal of the Institute of Convergence Signal Processing
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    • v.14 no.3
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    • pp.147-153
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    • 2013
  • Functional game, which is the combination of play and learning and a futuristic tool, can minimize the dysfunction and maximize the proper functions, and furthermore, has taken root as a new alternative that can change the game industry and game culture. Recently, the focus of game and education markets is shifting to the development of more advanced learning contents, rather than emphasizing the self-control and motivation of users. Along with that, the game market has excluded the socially dysfunctional elements, such as the addiction and learning disabilities, and has witnessed a diversification into the human-friendly entertainment business that emphasizes the mental and physical health and pursues scientific educational effects. In addition, functional games are expanding its reach from the professional sectors - such as medical aide/medical learning, military simulation, health, auxiliary tools, special education and learning tools - to the realm of routine education, mental health, etc., and has seen a steady growth. However, most functional games, which are being currently planned and developed to cope with the special characteristics of the market, have not undergone accurate scientific assessment of their functions and have not proven their effectiveness. An overwhelming proportion of the functional games are being developed based on the intuition and experience of game developers. Moreover, the type of games, which involve the repetition of simple tasks or take the form of simple puzzles, cannot effectively combine the practically interesting factors and the learning effects. Most games incorporate unscientific methods leading to the vague anticipation of improvement in functions, rather than the assessment of human functions. In this paper, a study was conducted to present the measures that could maximize the effects of functional games in relation to the changes in the visual and auditory stimulations in order to maximize the effects of functional games, i,e., the immersion and concentration. To compare the degree of effects arising from the visual stimulation, the functional game contents made in the form of 2D and 3D were utilized. In addition. ultra sound and 3-dimensional functional game contents were utilized to compare the degree of effects resulting from the changes in the auditory stimulation. The brainwave of the users were measured while conducting the experiments related to the response to the changes in visual and auditory stimulations in 3 steps, and the results of the analysis were compared.

A Case Report on Opioid-Induced Constipation in a Patient with Cancer Treated by Jowiseunggi-tang (조위승기탕으로 호전된 암 환자의 마약성 진통제로 인한 변비 치험 1례)

  • Yoon, Jee-Hyun;Park, Su Bin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.229-236
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    • 2022
  • Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.

Effects of Combined Cognitive and Physical Exercise Program on Cognitive and Physical Functions in Older Adults with Mild Cognitive Impairment

  • Hyungyu Cha;Hyeyeon Shim;Geonwoo Kim;Seunghoon Bae;Changmin Lee;Youngjun Choi;Wonjae Choi
    • Physical Therapy Rehabilitation Science
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    • v.13 no.1
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    • pp.43-52
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    • 2024
  • Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.

Effects of Exercise on Cardiopulmonary Functions and Shoulder Joint Functioning in Breast Cancer Patients undergoing Radiation Therapy after Breast Surgery (유방암 수술 후 방사선치료중인 환자를 위한 운동프로그램이 심폐기능 및 어깨관절기능에 미치는 효과)

  • 채영란;최명애
    • Journal of Korean Academy of Nursing
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    • v.31 no.3
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    • pp.454-466
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    • 2001
  • Purpose: The purpose of this study was to determine the effects of exercise program on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who under- went radiation therapy after surgery. Method: Subjects in the experimental group(N=12) participated in an exercise program for eight weeks. The Exercise program consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal oxygen uptake (v2max), maximal running time, shoulder joint range of motion, and shoulder functional assessment were determined before and after the exercise program. Baseline sociodemographic and medical data were compared between experimental group and control group using the Fisher's exact test and Mann- Whitney U test. For effects of the exercise program, repeated measures ANOVA were used. Result: 1) Following the exercise program for eight weeks, both v$\alpha$ max and maximal running time tended to increase in experimental group comparing with the control group. 2) Shoulder abduction, extension and flexion of the operated upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). 3) Shoulder flexion of the normal upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). Conclusion: The results suggest that the exercise program for breast cancer patients undergoing radiation therapy after breast surgery can improve shoulder functions and increase cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.

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NFlex Dynamic Stabilization System : Two-Year Clinical Outcomes of Multi-Center Study

  • Coe, Jeffrey D.;Kitchel, Scott H.;Meisel, Hans Jorg;Wingo, Charles H.;Lee, Soo-Eon;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.343-349
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    • 2012
  • Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

Reliability of the Neck Pain and Disability Scale in Neck Pain Patients (경통 환자들을 위한 Neck Pain and Disability Scale의 신뢰도 연구)

  • Shin, Won-Seob;Lee, Eun-Woo;Jung, Kyoung-Sim;Lee, Suk-Min;Chung, Yi-Jung
    • Physical Therapy Korea
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    • v.15 no.1
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    • pp.77-85
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    • 2008
  • The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.

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