• Title/Summary/Keyword: Mental disability assessment

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Discourses on Mental Health Act Revision and Critical Analysis on Mental Health Promotion and Welfare Service Support Act (정신보건법 개정 담론에 근거한 정신건강증진 및 정신질환자 복지서비스 지원에 관한 법률 주요 쟁점 분석)

  • Kim, Moon Geun
    • Korean Journal of Social Welfare Studies
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    • v.47 no.3
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    • pp.85-111
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    • 2016
  • This study aims to analyse major changes of Mental Health Promotion and Welfare Service Support Act(MHPWSSA) and critically discuss these changes based on the major discourses on Mental Health Act revision. For this purposes this study reviewed literatures and government reports to understand human rights discourses, welfare discourses, and prevention discourses. Secondly, the major changes of MHPWSSA were analysed and discussed based on those discourses. This study found that MHPWSSA defined the concept of people with mental disorders narrowly, tightened the involuntary admission procedures, introduced welfare service support provisions and mental health promotion provisions. But this study shows that the new legislation may well be criticised due to neglect of the concept of disability and people with psychiatric disability, involuntary admission without mental capacity assessment, neglect of the basic values and principles of self determination and independent living common in welfare of the persons with disability. And the new legislation may be criticised due to overuse of the concept of mental health promotion as encompassing promotion, prevention, treatment and rehabilitation.

Health-related Quality of Life in Korean Patients with Rheumatoid Arthritis: Association with Pain, Disease Activity, Disability in Activities of Daily Living and Depression (류마티스 관절염 환자의 건강관련 삶의 질 영향요인 분석: 통증, 질병활성도, 일상생활 수행능력 장애 및 우울과의 관련성)

  • Uhm, Dong-Choon;Nam, Eun-Sook;Lee, Ho-Yeon;Lee, Eun-Bong;Yoon, Young-Im;Chai, Gong-Ju
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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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.

Long-Term Care Needs Assessment of the Disabled Workers After an Industrial Injury (산재장해인의 장기요양서비스 요구 분석)

  • Choi, Eun Sook;June, Kyung Ja
    • Korean Journal of Occupational Health Nursing
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    • v.16 no.2
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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.

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Indicator of Diagnosing Fatigue by Analyzing Questionnaire Data (설문지를 이용한 피로 진단 지표 연구)

  • Yoon, Tak-Hyun;Park, Soo-Jung;Choi, Na-Rae;Jin, Ming;Joo, Jong-Cheon;Kwon, Young-Mi
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.17 no.3
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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.

Cognitive Assessment in Complex Regional Pain Syndrome Patients (복합부위통증증후군 환자의 인지기능 평가)

  • Moon, Jee Youn;Kim, Yong Chul;Park, Mi Jung;Lee, Pyung Bok;Lee, Sang Chul;Kang, Do Hyung;Shin, Min Sup;Kwon, Tae Myung
    • The Korean Journal of Pain
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    • v.22 no.1
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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.

A Comparative Study on Evaluation Methods of Permanent Impairment in Korea (우리나라의 신체장애평가법에 관한 비교연구 - 신체장해등급법, McBride법, 미국의학협회 (AMA)기준법을 중심으로 -)

  • Rhee, Chang-Ok;Choi, Jung-Keun;Son, Mi-A;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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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.

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THE ADDITIONAL POINT SYSTEM OF NATIONAL HEALTH INSURANCE FOR DENTAL TREATMENT IN PATIENTS WITH A SPECIAL HEALTH CARE NEED IN KOREA (한국의 장애인 환자 치과 진료를 위한 국민 건강 보험 가산제도의 종류 및 청구 현황)

  • Kwon, Doyoun;Nam, Okhyung;Kim, Misun;Choi, Sungchul;Kim, Kwangchul;Choi, Jaeyoung;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.1
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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.

Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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Assessing the Functional Status of Acute Stroke Patients using ICF Core Set-short Form (단축형 ICF 핵심지표로 측정한 뇌졸중 환자의 기능상태)

  • Kang, Jiyeon;Gong, Ju;Park, Mi-Jin;Lee, Yeo-Won;Kim, Yuri
    • Journal of muscle and joint health
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    • v.20 no.1
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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.

A Statistical Analysis of the General Anesthesia for Dental Treatment to Children with Developmental Disability (장애 환자의 소아치과 치료 시 전신마취에 대한 통계적 고찰)

  • Choi, Young-Kyoo;Lee, Sung-Min;Kim, Dong-Ok
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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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.

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