• 사회복지연구
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• 제47권3호
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• pp.85-111
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• 2016

본 연구는 정신보건법의 전면 개정 법률인 정신건강복지지원법(정신건강증진 및 정신질환자 복지서비스 지원에 관한 법률)의 주요 쟁점을 분석하고, 그 함의가 무엇인지 규명하기 위한 연구이다. 이를 위해 첫째, 정신보건법 개정과 관련한 주요 담론인 인권담론, 사회복지담론, 예방담론의 구체적 내용을 비판적으로 검토하고, 둘째, 정신건강복지지원법의 주요 쟁점을 분석하고 함의를 논의하였다. 정신건강복지지원법 주요 쟁점 분석결과 이 법률은 정신질환자 개념이 축소되어 장애인복지법의 정신장애인 개념에 근접하는 것으로 나타났고, 입원규정은 비자발적 입원요건을 강화했으나 정신질환자의 주체성을 강화하지 못한 것으로 나타났다. 또한 사회복지서비스는 도입하였으나 장애인복지서비스의 핵심 가치인 장애인의 당사자주의와 같은 핵심적 가치는 부정하고 있었다. 정신건강증진은 예방, 치료, 재활, 복지를 포괄하는 개념으로 정의되어 정부 정신건강정책을 포장하는 상징적 성격이 강하고, 예방에 관한 초점을 약화시킬 우려가 있는 것으로 나타났다. 또한 정신보건법과 정신장애인복지지원법의 기계적 결합으로 내적 가치, 원리, 개념의 불일치라는 한계가 있었다.

• 대한간호학회지
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• 제42권3호
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• pp.434-442
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• 2012

Purpose: The purpose of this predictive study was to identify factors affecting health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA). Methods: The participants in this study were 131 patients with RA who were recruited from the outpatient clinic of a university hospital in Seoul. Disease activity in rheumatoid arthritis was evaluated by calculating the Disease Activity Score 28. Disability in activities of daily living (ADL) was assessed with the Korean Health Assessment Questionnaire, and depression with The Center for Epidemiologic Studies Depression Scale. HRQoL was evaluated using The Short Form 36 Health Survey. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. Results: Pain, disability in ADL, disease activity, and depression correlated negatively with physical and mental dimensions of HRQoL. But hierachical multiple regression analysis revealed that disability in ADL and depression were the only variables negatively influencing physical and mental QoL after adjustment for influences of sociodemographic variables. Conclusion: Results of this study suggest that disability in ADL and depression, rather than disease activity and pain have profound effects on HRQoL in patients with RA. Further studies are needed to assess the predictive ability of disease activity and pain on HRQoL in this population.

• 한국직업건강간호학회지
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• 제16권2호
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• pp.188-196
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• 2007

Purpose: The objective of this study was to evaluate long-term care needs using RAI MDS-HC and MI-CHOICE among the disabled workers. Methods: Data were obtained from 45 personal care recipients with the disability of mental and nervous system, and analyzed using SAS 9.1 by applying t-test, ${\chi}^2$ test, or fisher's exact test. Results: Only 'bed mobility' and 'indoor ambulation' items of ADL and problem activity were statistically significant factors by the level of personal care benefit. By MICHOICE grouping, 20.0 percent of subjects belonged to nursing home group, 51.5 percent were home care service, 28.9 percent were intermittent personal care. Conclusion: Personal care services in industrial accident compensation insurance have been categorized with two groups according to level of disability. But our results could contribute to provide personal care service according to the long term care needs.

• 대한한의진단학회지
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• 제17권3호
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• pp.179-188
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• 2013

Objectives This study was designed to development the diagnosis indicators for the fatigue group without disease using analysis of questionnaire data. Methods The subjects were divided into three groups, the fatigue group with disease, the fatigue group without disease, non-fatigue group without disease. Thirteen kinds of questionnaire (Fatigue visual analogue scale, Fatigue severity scale, Pain visual analogue scale, Short-form McGill pain questionnaire score, Headache impact Test-6, Neck disability index, Oswestry low back pain disability questionnaire score, Blood stasis assessment scale, Physical activities questionnaire score, Beck depression inventory, Anger expression inventory score, Mood disability scale, Job stress scale) were carried out for the subjects. Results The results of this study are ; 1) The weight, the systolic and diastolic blood pressure were different among three groups. 2) Among nine questionnaires related to the physical or life conditions, the averages of eight questionnaires were not same one another. 3) Among four questionnaires related to the mental condition or autonomic nervous system, the averages of Beck depression inventory were not same one another. Conclusion The fatigue group without disease can be diagnosed through using the both the questionnaires related to the physical or life condition and the those related to the mental condition or autonomic nervous system.

• The Korean Journal of Pain
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• 제22권1호
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• pp.28-32
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• 2009

Background: Complex regional pain syndrome (CRPS) is characterized by severe neuropathic pain and disability, which can result in psychological and behavioral dysfunction. The goal of the present study was to evaluate neurocognitive disability, and to assess the relationship between clinical variables and neuropsychological features in CRPS patients. Methods: We investigated the neuropsychological features of 15 CRPS I patients. The neuropsychological tests that we made comprised of a full intelligence quotient, memory quotient, trail-making test A, trail-making test B (TMT-B), and MMPI (Minnesota multiphasic personality inventory). Results: The results showed severe disability in performance on TMT-B. There was no significant correlation between specific cognitive variables and MMPI scales. Conclusions: Decreased performance on TMT-B which shows mental flexibility in the prefrontal lobe exists independently from depressive disorders in CRPS patients.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.627-651
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• 1994

In this study, literature review was done to examine and compare the current status and problems of different evaluation approaches toward permanent impairment in Korea. Alternatives and improvements in the current approaches in Korea were suggested. Series of cases were also examined to compare different approaches applied to the real cases, using 105 cases from a hospital data and another 207 cases from a insurance company data. The main findings of the literature review are as follows; 1. The current evaluation methods of permanent impairment in Korea are grouped into two categories, grading and rating. Gradings of impairments are expressly specified in 17 various statutes. 2. In Grading methods, the rigid system of 74 different grades has been adopted uniformally for the convenience of administration, which may not be, appropriate or valid from medical and scientifical aspect. 3. The adventage of McBride method is assessment of occupational disability rate. However the classified compensable occupations are only 280 and limited to manufacturing industries in 1960s'of U.S.A., which is not appropriate to current Korean circumstances. Especially, the job list does not include managerial officers or mental workers. 4. AMA Guides is the scientific and reasonable method for the assessment of physical impairment rate. However compensation and reparation of impairment case is difficult because this method cannot assess the disability rate according to occupation, age, etc. The results of cases comparative study are as follows: 5. The physical Impairment could be compared in 167 out of total 312 cases, and for the cases of complex impairment, McBride method underestimate physical impairment rate compared with AM A method. 6. When disability late was assessed, occupation was considered the compensation of only 85 cases, and age was used in only 21 cases. This was because occupation and age compensation in McBride method are unreasonable. 7. The most Ideal alternative is to assess physical impairment according to AMA method and then to develop a compensation method appropriate for the circumstances of Korea society.

• 대한장애인치과학회지
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• 제14권1호
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• pp.11-16
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• 2018

In order to increase the accessibility of dental care for people with disabilities, National Health Insurance Service has implemented an additional point system of National Dental Insurance for dental treatment of patients with a special health care need (AID). The purpose of this study is to investigate the types and status of AID in Korea using data of the Health Insurance Review and Assessment Service from 2011 to 2017. The basic consultation fee is increased by 9.03 points (713 won) for brain disorder, intellectual disability, mental disability, or autistic disorder. From 2011 to 2015, the number of claims with a basic consultation fee increased from 90,456 to 141,179. Dental treatment and surgical treatment fee is increased by 100% of the defined insurance score for each of the 15 items. During the five years from 2012 to 2016, the number and amount of claims for each item increased steadily. Of the total claims for 5 years, endodontic treatment was highest, with 107,477 cases, followed by 51,641 cases of scaling. There are two types of dental safety observation fee, simple and complex. The simple safety observation fee is 10,370 won per day, and the complex safety observation fee is 20,750 won per day. Dental safety observation fees were charged 34 times in 2015, 14 times in 2016, and 41 times through May 2017. From 2011 to 2017, the number and amount of claims using AID for dental care for people with disabilities increased. However, considering that the number of registered dental users with disability was about 560,000 in 2016, the number of claims using AID is 1-20,000, which is less than 2% of registered dental users with disability. Therefore, it is necessary to expand dental services for people with disabilities including AID.

• 정신신체의학
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• 제9권1호
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• pp.28-36
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• 2001

연구목적 : 두부외상 후 장애평가를 받기 위해 정신과에 입원했던 환자들의 뇌 영상검사 이상유무에 따른 인구 통계학적 특성, 정신의학적 증상, 두부외상형태, 임상 심리학적 특성 등을 비교하고자 하였다. 방법 : 1994년 1 월부터 1998년 12월까지 두부외상 후 장애 평가 목적으로 조선대학교병원 정선과에 입원한 환자 중 뇌 영상검사를 실시한 59명의 환자를 대상으로 하였다. 병록기록지와 장애 평가서를 근거로 하여 뇌 영상검사 이상소견이 있는 27명의 환자군과 이상소견이 없는 32명의 환자군 사이의 임상적 특정을 비교 분석하였다. 결과 : 뇌 영상검사에 이상소견이 있는 환자군(병변군)은 이상소견이 없는 환자군에 비해 나이가 더 많았으며, 학력은 더 낮았다. 정신의학적 증상측면에서, 병변군은 수상 후 정신증 발생빈도가 유의하게 높았으며 식욕 감퇴, 허무사고, 기억력 감퇴소견이 더 많았다. 그러나 환청의 빈도는 오히려 더 적었다. 두부외상형태에서 병변군은 수상시 뇌출혈, 뇌수술빈도가 유의하게 더 높게 나타났다. 임상심리학적 검사에서 병변군은 BGT상 이상소견이 유의하게 더 많았고, 지능검사에서는 공통성문제와 토막짜기에서 더 낮은 점수를 받았으며, MMPI 검사에서는 F척도, 건강염려증척도, 우울증척도 히스테리척도, 반사회성척도, 정신쇠약증척도, 정신분열증척도등에서 유의하게 더 낮았다. 결론 : 수상시 뇌출혈이 있고 뇌수술을 받았던 환자에서 뇌 영상검사 이상소견의 빈도가 많았고, 인지증상과 정서증상을 더 많이 호소하였다. 뇌 영상검사 이상소견이 있는 환자군은 추상적 개념형성과 지각적 조직화능력이 떨어지고, MMPI 하위척도들에서 전반적으로 더 낮은 점수를 받았다.

• 근관절건강학회지
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• 제20권1호
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• pp.22-30
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• 2013

Purpose: The International Classification of Functioning, Disability and Health (ICF) model was proposed by the World Health Organization for enhancing interdisciplinary communication. The purpose of this study was to examine the functional status of acute stroke patients using ICF core sets-short form. Methods: A set of 15 ICF items on functional status was used by nurses for their daily nursing assessment on functional status in 44 acute stroke patients in a university hospital. Results: The highest level of function was "consciousness", while the lowest was "defecation". Compared with functional status on the first day, consciousness, ingestion, language (mental), and defecation functions were significantly improved on the 14th day. However, there was no significant changes in items on activity and participation or environmental functions. Conclusion: These findings suggest that the function-specific nursing interventions for acute stroke patients need to be developed. Future research needs to test the usefulness of ICF items as an measurement tool.

• 대한치과마취과학회지
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• 제2권2호
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• pp.101-106
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• 2002

Background: The management of the behavior of handicapped children when providing required dental care is often a problem, whether in the dental office or in a hospital setting. Because of the high incidence of poor cooperation, many of these patients are scheduled for dental care under general anesthesia with preoperative medical assessment. The purpose of this study was to carry out a clinico-statistical survey on dental treatment for handicapped children under general anesthesia. Methods: After approval from the institutional review board, the medical records of 64 handicapped children between 1997 and 2002 were reviewed to determine the patient profiles, anesthesia management, and complications. The charts of these patients, who underwent dental examination, scaling and prophylaxis, and restoration and extraction of teeth under general anesthesia, were reviewed. Results: The mean age was 12.8 years old, and males (53%) predominated females (47%). Twenty-four patients had mental retardation, twelve had autism, six had cerebral palsy, 4 had behavior disorder, others had heart disease, convulsive disorder, etc. Sixty-two had intravenous thiopental with neuromuscular blocker, 2 had intravenous ketamine induction. Nasotracheal intubation was uneventful in 55 patients, nine had orotracheal intubation because of difficult visualization of the larynx. Twenty-one patients experienced postoperative complications in the recovery room, including epistaxis, nasal obstruction, vomiting, airway obstruction, respiratory depression. Conclusions: General anesthesia is a very effective way of completing the dental treatments for disabled children. We emphasize the need to train anesthesiologists in the care of disabled patients.