• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Science of Emotion and Sensibility
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• v.13 no.3
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• pp.581-596
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• 2010

The purposes of this study are to investigate and analyze the level of information and the state of digital divide of the disabled by surveying the demand for information and communication assistive devices, and to provide basic data for plans on the development and utilization of information and communication assistive devices. In order to understand the actual condition and the state of digital divide of persons with disabilities, the differences of possession and accessibility of information technology devices, usage ability, and utilization were analyzed according to the disability profile by using the T-test. The results show that there are significant differences (T=-2.510*) of possession and accessibility of information technology devices with respect to the disability profile, and that the disabled have lower possession and accessibility of devices than the non-disabled. Result of this study's demand forecast shows that about 28% of total respondents are currently using information and communication assistive devices, and a majority (67%) of them answered that the use of assistive devices lend great help to their lives. The proportion of those who have been supported by the government or related organizations with information and communication assistive devices were 36% of the total respondents, and those satisfied with the performance of the devices were 46% of the total responses. Meanwhile, only 36% of total users answered that the operation and use of functions of the devices was easy and convenient, responding that the difficulty of operating assistive devices was the greatest inconvenience. Moreover, the general requests of respondents in regards to the devices were stabilization of device performance, miniaturization of size, simplification of buttons, and reduction of weight.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.520-526
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• 2020

Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

• Journal of Popular Narrative
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• v.25 no.4
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• pp.263-288
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• 2019

Barrier-free films enhance accessibility to audiovisual image contents by providing specific information on screen and through sound so that people with vision or hearing loss can receive the same amount of information as those without disabilities and immerse themselves in the audiovisual images. This study pays attention to barrier-free audiovisual contents in relation to the cultural civil rights of people with vision or hearing loss in South Korea. While institutional efforts have been made in the 2010s to improve the access to audiovisual media of people with vision or hearing loss, the goal of enabling people with vision or hearing loss to fully enjoy all audiovisual contents at a level equal to the non-disabled has not yet been realized. Amid the lingering conflict between disabled groups and multiplexes that has lasted years, the global video streaming service Netflix has aggressively threatened the dominance of local multiplexes with the launch of its Korean service. As Netflix, which is subject to U.S. regulations guaranteeing the rights of people with vision or hearing loss, has produced original dramas and movies involving Korean production teams, the cultural civil rights discourse of the disabled has transitioned to the issue of the rights of cultural consumers crossing national borders in the era of globalization. Changes in the media environment raise the issue of civil rights guarantees in which disabled people enjoy the right to simultaneously watch movies and comment on movies by participating in a common discourse, equally with non-disabled people. The "right to be part of the audience for Korean cinema" for Korean deaf people, which has long been neglected, should also be considered as a cultural civil right that crosses the boundaries of language, nation and disabilities. This essay examines the current issues surrounding the right to cultural entertainment of people with vision or hearing loss in South Korea in conjunction with the contemporary trend of rapid changes in the media environment and the global spread of the movement for cultural civil rights of people with disabilities, and suggests the need for visual culture studies to take a serious step toward disability studies.

• Journal of Korean Society of Spine Surgery
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• v.25 no.4
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• pp.147-153
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• 2018

Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.122-140
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• 2001

The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.830-837
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• 2007

Background and purpose : Stroke is one of the most deadly diseases and a leading cause of disability. Lipids confer an increased risk for cardiovascular morbidity and mortality. In spite of many studies on the relationship between stroke and lipids, their relationship is not clear. This study was undertaken to determine whether lipids were associated with stroke. Method : We compared the components of blood lipids between stroke patients group (n=217,Cases), non-stroke control group (n=160, Controls) and healthy control group without hypertension, diabetes mellitus, ischemic heart disease, or hyperlipidemia (n=140, Normals). These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Result : The results were as follows. The blood levels of total cholesterol (T-Chol), triglyceride (TG) and low density lipoprotein cholesterol (LDL-Chol) were significantly higher in patients of ischemic stroke, while the blood levels of T-Chol and LDL-Chol were significantly lower, and the blood levels of TG significantly higher in patients of hemorrhagic stroke. The blood level of high density lipoprotein cholesterol (HDL-Chol) was significantly lower in all cases. Conclusion : These results suggest that high TG and low HDL-Chol may be risk factors of hemorrhagic stroke and ischemic stroke, high T-Chol and LDL-Chol may be risk factors of ischemic stroke, and low T-Chol and LDL-Chol may be risk factors of hemorrhagic stroke in Koreans.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.87-101
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• 2019

Objectives The purpose of this study is to investigate characteristics of low back pain patients and trends of Korean medicine conservative treatment effects of low back pain patients by registry data. Methods A total of 78 patients were analyzed, statistical analysis was performed using a generalized linear model. The comparison between groups was performed using independent two samples t-test or Wilcoxon rank sum test according to the distribution of normality. Before and after the treatment effects, ANOVA and Kruskal-Wallis method were used for the comparison, Sheffe method was used for the post test. Results The average age of hospitalized patients was 31.8 years old and out-patient department (OPD) patients was 44.9 years old. Lots of OPD patients and hospitalized patients were classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis'. Both OPD patients and hospitalized patients classified to 'Lumbago due to Coexist Qu Stagnation and Bloos Stasis' showed statistically significant decrease in RMDQ (Roland-Morris disability questionnaire) and NRS (numeric rating scale) on 1 month and 3 month after clinical research start date. Comparing the treatment effects of Chuna manual therapy, both Chuna group and non-Chuna group showed statistically significant decrease in RMDQ and NRS on discharge date, 1 month and 3 month after clinical research start date. Conclusions We expect that a larger scale registry study will be carried out to provide a higher level of basis for the Korean medical treatment of low back pain.

• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.314-327
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• 1999

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.8 no.1
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• pp.27-38
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• 2013

Objectives : The purpose of this study is to investigate the latest trends of korean Medicine treatments on traffic accident for recent 5 years. Methods : We investigated the studies on korean Medicine treatments for traffic accident via searching 6 Korean web databases. As a result, 65 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the number of cases, the sites of injury, the types of treatments the instruments for assessment and ethics approvals. Results : 65 articles were published since 2008. The studies on korean Medicine treatments about traffic accident were mainly published in Journal of Oriental Rehabilitation Medicine. 10 case studies, 14 case series, 11 non randomized controlled trials, 21 randomized controlled trials and 9 systemic reviews had been under research. The most frequently occurred symptoms were neck pain and low back pain. In most studies, various korean Medicine treatments were used to treat the symptoms. Visual analogue scale(VAS) and neck disability index(NDI) were used as primary assessments. In most clinical studies, there were no mention about approval of institutional review board(IRB). Conclusion : In this study, we analyzed the trends of korean Medicine treatments on traffic accident from 2008 to 2012. Reviewing the domestic trends of studies on korean Medicine treatments for traffic accident and examining the strong and weak points of those treatments are essential for the future studies. It is needed to adopt the qualitative methods of evaluation in order to develop a level of evidence.