• Title/Summary/Keyword: Health care use

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A Systematic Review on the Effects of Robot-Assisted Therapy for Stroke Patient (뇌졸중 환자에서 로봇보조치료 효과에 관한 체계적 고찰)

  • Park, Jin-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.2 no.2
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    • pp.21-36
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    • 2013
  • Objective : The purpose of this study was to look at a systematic review on the effects of robot-assisted therapy on stroke rehabilitation in upper limbs. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from June 2012 to September 2012, using EMBASE, MEDLINE, etc. 12 studies(randomized controlled trials) were included in the analyses. Results : Selected 12 studies were Pedro score 2 or more. The primary outcome measure tools including tools for upper extremity function and activities daily of living were used. Through various intervention, Robot-assisted therapy maximizes the effectiveness of intervention. The effects of upper extremity function and functional ability(ADL) by robot-assisted therapy showed significant effect, but no difference exists between the robot-assisted therapy and conventional therapy groups in terms of upper extremity function and functional ability. Conclusions : Robot-assisted therapy has been widely used clinically for stroke patients to maximize the effect had been applied to various interventions. Robot-assisted therapy depending on the methods of intervention showed that the effect of difference. In the future study, the use of robot-assisted therapy applied to a variety of interventions is needed on occupational therapy.

Studies on the variations of hospital use and the changes in hospital revenues of 10 KDRGs under the PPS (일개 대학병원의 환자군별 진료서비스 변이와 포괄수가제 적용에 따른 진료수익 변화)

  • 전기홍;송미숙
    • Health Policy and Management
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    • v.7 no.1
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    • pp.100-124
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    • 1997
  • In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

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The Patterns of Accidental Injury in Young Children and Effect of Safety Education on Their Mothers Performance of Preventive Measures (영유아의 사고유형 실태조사와 안전교육 효과 분석)

  • Song In-Ja;Han Jung-Suk
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.55-74
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    • 1998
  • In the past most major accidents resulted in death, but today there is a dramatic increase in the number of people who survive such accidents but who are left with permanent injury. Particularly, children who are inquisitive about their surroundings but immature in their ability to assess danger, are more vulnerable to accidents and their causes as well as to determine attitudes towards prevention. The main objective of the study was to assess the effectiveness of using an accident prevention manual for accident for accident prevention education. The study was a quasi-experimental study using a questionnaire format. The subjects of the study were 393 mothers of children attending six day care centers in Seoul. Data collection was done between May 1 and June 15, 1997. The tools used for the study were a questionnaire developed the researchers and a manual for accident prevention. The collected data were analyzed using SPSS. The results of the study are as follows: 1. Types of accidents included stabbing, bums, falls from heights, choking, falls on slippery surfaces, traffic accidents, drowning, poisoning, and electrical shock in that order of frequency. 2. The main causes of accidents in children were from cosmetics and household medications. 3. The most frequent locations of accidents in the home were the bathroom, kitchen, and stairways in that order. 4. For $90.4\%$ of children safety seats were not used when the ridding in a car. 5. In examining the parents' accident prevention practices, it was found that many parents used only . one electrical outlet for many appliances, tending to overload the electricity lines and that they were not practically concerned bout the flammability of children's pajamas, indicating a less than positive attitude towards fire prevention. 6. The parents had not provided their children with any instruction on accident prevention or on what to do after an accident had occurred. 7. After the use of pamphlet in an accident prevention education program, it was found that there was a statistically significant difference in the degree to which children carried out safety measures (t=14.96, p=.000) and in their safety habits (t=-1.67, p<.1) indicating an effectiveness in this method of education. The results of this study showed that there are many things in a child's environment that can cause accidents and that the possibility of an accident occurring is high. So nurses looking after children should be aware of the need for safety education to prevent accidents in the home and plan to provide appropriate educational material to help parents with this education.

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Development of Wearable Physical Activity Monitoring System (웨어러블 신체 생체 활동 모니터링 시스템 개발)

  • Park, Eun-Ju;Park, Do-Young
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.11 no.1
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    • pp.34-39
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    • 2018
  • Along with the development of ICT technology, wearable devices of various sizes and shapes have been developed. In addition, performance and specifications are rebuilt with IOT fusion products so that they can connect with the current smartphone. This is one of the general-purpose technologies of the 4th industrial revolution, which is spot-lighted with technology that changes the quality and environment of our lives. Along with this, as new technology products combining health care technology increases, various functions are provided to users who need it. Wearable technology is ongoing trend of technology development. It also sells products developed as products in the form of smart watches. At present, various related products are made in various ways, and it is recommended to use the Arduino processor in accordance with the application. In this study, we developed wearable physical activity monitoring system using open source hardware based TinyDuino. TinyDuino is an ultra-compact Arduino compatible board made on the basis of Atmega process Board, and it can be programmed in open source integrated development environment(named Sketch). The physical activity monitoring system of the welfare body can be said to be a great advantage, as a smart u-Healthcare system that can perform daily health management.

The Major Elements of Psychological Assessment and Intervention for Children and Adolescents after a Disaster: A Professional Delphi Preliminary Survey (재난 시 소아청소년 정신건강 평가 및 치료의 주요 요소: 전문가 델파이 예비 조사)

  • Park, Jang-Ho;Lee, Mi-Sun;Chang, Hyoung Yoon;Hwang, Jun-Won;Lee, Ju-Hyun;Kim, Ji-Youn;Lee, Cheol-Soon;Kim, Eunji;Bae, Seung-Min;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.27 no.3
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    • pp.164-172
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    • 2016
  • Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

An Inquiry to the Causal Perceptions & Emotions of Rheumatoid Arthritis Patients (류마티스 관절염 환자의 원인지각에 대한 연구 - Q방법론적 접근 -)

  • Kim, Boon-Han;Jung, Yun
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.226-241
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    • 1999
  • This study was undertaken to find out the causal perception of rheumatoid arthritis patients, and to understand the typology. The Q-population consisted of 236 statements of causal perception were collected. Thirty eight Q-samples of causal perception were selected. The P-sample for this study were made up of 28 first visiting female rheumatoid arthritis patients from a rheumatoid arthritis specialty hospital. Each respondent responded Q-set of causal perception according to 9-point scale. The result of Q-sorting were coded and analyzed using QUANL PC program. 1) Typological Observation on Causal Perception (1) Physical Fatigue Type : Type 1 perceived that the illness occurred due to excessive work requiring physical labor or strain that had occurred from not resting after excessive physical labor, therefore, thinking the origin of the illness was from physical strain. (2) Physical origin Type : Type 2 perceived that the major cause for the illness is not only excessive physical labour but also fecundity and old age. (3) Causality to Environment Type : Type 3 perceived that rheumatoid arthritis occurred from injury to the joints or bad and humid weather. (4) Conscience of Guilty Type : Type 4 consisted of people with guilty conscience for lack of religious commitment. They perceived that the illness was a punishment from God for not praying or because of bad luck. (5) Rationally Perceiving Type : People who belong in type 5 perceived the cause of illness in light of scientific facts such as genetics, unbalanced diet or lack of exercise. (6) Psychological Stress Type : People who belong in type 6 believed that excessive stress was the cause of the illness. 2) Emotions of Rheumatoid arthritis patients Rheumatoid arthritis patients' positive emotions included determination, courage, coping, acceptance, hope, and adoption ; and their negative emotions were prostration, worry, stupor, conflicts, grievance, giving-up, resignation, depression, loss, solitariness, fear, anxiety, avoidance, anger and loneliness. Rheumatoid arthritis patients experience different level of emotions from their suffering experience from the severe pains. Rheumatoid arthritis patients also experience negative emotions when they could not perform self-care and lose their self-esteem from painful suffering ; however, they regain positive emotions when they recover from pain with the use of drugs, physical therapy or exercise. Their emotional states are closely connected to level of and presence of pain.

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The Restaurant Accessibility and Task Evaluation Tool: Development and Preliminary Validation (식당의 접근성과 활동 평가 도구: 개발과 예비 타당성)

  • Park, Minsoo;Park, Kang-Hyun;Park, Ji-Hyuk;Smith, Roger O.
    • Therapeutic Science for Rehabilitation
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    • v.9 no.3
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    • pp.35-51
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    • 2020
  • Objective : The purpose of this study was to develop and establish the preliminary validity of the Restaurant Accessibility and Task Evaluation Information Tool (RATE-IT), an electronic survey for evaluating restaurant accessibility for people with disabilities. Methods : A multi-phase method was used to develop and validate the RATE-IT. The taxonomy was developed in phase one, while the validity of the content was tested in phase two. Finally, the validity of the constructs was assessed in phase three. Results : The results indicated that appropriate items were included (relevance=0.99 and language level=0.99) and also supported that the RATE-IT evaluated the construct of restaurant accessibility (F=0.72, p=.40). When compared to a checklist of the Americans with Disabilities Act Accessibility Guidelines (ADAAG) for Buildings and Facilities questions, RATE-IT showed the potential to differentiate restaurants by their level of accessibility (p=.10). Further, the RATE-IT was also easy to use (p<.00), understandable (p<.00), and efficient (p<.00). Conclusion : RATE-IT shows a promising methodology and is strongly preferred by users.

Rutin Improves Bone Histomorphometric Values by Reduction of Osteoclastic Activity in Osteoporosis Mouse Model Induced by Bilateral Ovariectomy

  • Lee, Hye-Hwa;Jang, Jae-Won;Lee, Jung-Kil;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.433-443
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    • 2020
  • Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

Effects of 5 Weeks Self-Help Management Program on Reducing Depression and Promoting Activity of Daily Livings, Grasping Power, Hope and Self-Efficacy (재가 뇌졸중환자를 위한 5주간의 자조관리프로그램의 효과에 관한 연구)

  • Kim, Keum-Soon;Seo, Hyun-Mi;Kim, Eun-Jeong;Jeong, Ihn-Sook;Choe, Eun-Jeong;Jeong, Sun-I
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.196-211
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    • 2000
  • The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

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MULTIDISCIPLINARY APPROACH OF A PATIENT WITH MENTAL RETARDATION UNDER GENERAL ANESTHESIA : A CASE REPORT (정신지체 환자의 협력 진료에 의한 전신마취 하 치과치료 증례)

  • Jang, Yoon-Hyoung;Pae, Ah-Ran;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.23-26
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    • 2009
  • Mental retardation is defined by the American Psychiatric Association as" subnormal general intellectual functioning which originates during the developmental period and is associated with impairment of either learning and social adjustment or maturation, or both." A patient with mild to moderate mental retardation can be managed adequately using restraints and medications. However, in case of severe or profound mental disability, dental treatment cannot be accomplished even with the use of behavior modification, physical restraints and sedation techniques. When treatment in the dental office has much difficulty, hospitalization for dental treatment under general anesthesia can and should be considered. This case presents the treatment of a patient with mental retardation who was referred to our department for comprehensive dental care. Dental examination revealed widespread dental caries and a severe anterior open bite with crowding problems. Under general anesthesia, generalized caries treatment was performed by our department, and the anterior dental esthetics was achieved in collaboration with the department of prosthodontic dentistry.

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