• Title/Summary/Keyword: Patient-Centered

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Study on the Adolescent Patient′s Stress during Hospitalization (청년기환자의 입원생활에 따르는 긴장에 관한 연구)

  • 백영주
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.72-79
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    • 1976
  • Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

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The Implementation and Evaluation of Learning Experience-Based Professionalism Program in Medical School (의과대학의 학습경험 중심 전문직업성 프로그램 운영 및 평가)

  • Yoo, Hyo Hyun;Kim, Young Jon
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.164-172
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    • 2018
  • This study explores how to implement a learning experience-based professionalism program for a medical students and evaluates its program through effectiveness and usability test. This study aims to provide practical implications for experience-based learning in an undergraduate level. Seventy four first-year medical students enrolled in PDS1(Patient-Doctor-Society 1): professionalism, one-week block (30 hours), one-credit program based on a experience-based learning model. All of the students were given six learning themes and learning resources and supporting tools, and conducted stepwise learning activities; preparation, organization, sharing, reflection and evaluation of experiences. The effectiveness of learning was evaluated by comparing the pre and post results of student's self-assessment on 24 questionnaire items about professionalism. After the course, the students and instructors conducted a usability evaluation of the program through questionnaires or group interviews. Learners' self-assessment results of professionalism such as leadership, self-directed learning, professional attitude, and social accountability all showed significant differences between the pre- and post-test. Satisfaction of the program was distributed to 3.58~3.78 according to items. Instructors and learner interviews confirmed practical usability throughout the course design, implementation and students evaluation. The results of the study showed the feasibility of implementing learning experience-based professionalism program in medical school. This study provides practical implications to develope and evaluate the learning experience-based professionalism program in medical education.

A Survey on Patient's Experience on Health Care Utilization and Perception of Health Care System for Developing of a Korean Medicine Clinical Practice Guideline for Traffic Injuries (교통사고상해증후군 한의표준임상진료지침 개발을 위한 환자의 의료이용 경험과 의료체계 인식도 설문조사 연구)

  • Park, Sun-Young;Lee, Sang-Hyun;Heo, In;Hwang, Man-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Park, Kyoung Sun;Ha, In Hyuk;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.139-152
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    • 2020
  • Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

A study on the development of hospital rounds information system utilizing NFC (NFC를 활용한 병원 회진 안내 시스템 개발에 관한 연구)

  • Lee, Hyo Seung;Oh, Jae Chul
    • Smart Media Journal
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    • v.5 no.3
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    • pp.67-73
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    • 2016
  • Now, Korean health technology and health service is proud to be world class one at a level of not falling behind anywhere in the world. However, this health service has been provided, centering on hospital or medical staff, not patient so far. And there is a tendency to gradually change into patient-centered health service. According to the results of survey performed by Korea Institute for Health and Social Affairs, it was reported that, as of 2016, 30% or more of inpatients were not sufficiently given information relating to hospital rounds, and in particular, 50% or more of inpatients in their twenties to thirties expressed discontent, and approximately 17% of inpatients in their seventies and beyond expressed discontent. In the light of these data, especially inpatients in their twenties to thirties want information relating to hospital rounds and the like. And taking into consideration that they are characterized by being accustomed to using a smartphone, it is intended to design and implement a hospital rounds information smartphone application. Now, in some of medium and large hospitals, information about hospital is provided through smartphone application. However, the main purpose is hospital information or outpatient's appointment to see a doctor and so on. Even in case of providing information about hospital rounds, only information about approximate time to make rounds is provided. This paper is intended to design and implement hospital rounds information system making it possible to check their turn when rounds are made by utilizing NFC function in smart phone.

Analysis of Lower Extremity Injury Mechanism Centered on Frontal Collision in Occupant Motor Vehicle Crashes (정면충돌 시 차량 탑승자의 하지 손상기전에 대한 분석)

  • Lee, Hee Young;Lee, Jung Hun;Jeon, Hyeok Jin;Kim, Ho Jung;Kim, Sang Chul;Youn, Young Han;Lee, Kang Hyun
    • Journal of Auto-vehicle Safety Association
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    • v.10 no.4
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    • pp.7-12
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    • 2018
  • Injury mechanisms of lower extremity injuries in motor vehicle accidents are focused on fractures, sprains, and contusions. The purpose of this study is to evaluate the analysis of lower extremity injury mechanism in occupant motor vehicle accident by using Hospital Information System (HIS) and reconstruction program, based on the materials related to motor vehicle accidents. Among patients who visited the emergency department of Wonju Severance Christian Hospital due to motor vehicle accidents from August 2012 to February 2014, we collected data on patients with agreement for taking the damaged vehicle's photos. After obtaining the verbal consent from the patient, we asked about the cause of the accident, information on vehicle involved in the accident, and the location of car repair shop. The photos of the damaged vehicle were taken on the basis of front, rear, left side and right side. Damage to the vehicle was presented using the CDC code by analytical study of photo-images of the damaged vehicle, and a trauma score was used for medical examination of the severity of the patient's injury. Among the 1,699 patients due to motor vehicle crashes, 88 (5.2%) received a diagnosis of lower extremity fracture and 141 (8.3%) were the severe who had ISS over 15. Nevertheless during 19 months for research, it was difficult to build up in-depth database about motor vehicle crashes. It has a limitation on collecting data because not only the system for constructing database about motor vehicle crash is not organized but also the process for demanding materials is not available due to prevention of personal information. For accurate analysis of the relationship between occupant injury and vehicle damage in motor vehicle crashes, build-up of an in-depth database through carrying out various policies for motor vehicle crashes is necessary for sure.

Necessity of revision of the mandatory medication guidance regulation under the Pharmaceutical Affairs Act (약사법상 복약지도의무 규정의 개정 필요성)

  • Dawoon Jung
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.119-145
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    • 2023
  • The Pharmaceutical Affairs Act stipulates medication counseling as an obligatory requirement in the case of preparation of medicine. In fact, there are many cases where pharmacists only tell patients the dose and time and do not properly guide them on taking medications. However, in light of the current situation where non-face-to-face treatment is being attempted, there is a high possibility of drug-taking accidents due to insufficient medication guidance. In addition, as an aging society progresses, the need for explanations on pharmaceuticals is increasing. If a pharmacist causes damage to a patient by failing to give appropriate medication guidance, the patient can claim compensation for damages. In addition, if a drug accident occurs due to a conflict between the pharmacist's duty to guide medication and the doctor's duty to explain, a joint tort is established between the pharmacist and the doctor. Nevertheless, there are cases in which only doctors are judged to bear the tort liability. However, the Pharmaceutical Affairs Act includes providing information for the selection of over-the-counter drugs in the medication guidance as part of the medication guidance obligation. Therefore, in order to reconsider the importance of the medication-taking guidance duty, it is necessary to define the medicationaking information provision method and the medication-taking guidance duty as separate concepts. In addition, it is necessary to amend related regulations centered on patients so that medication guidance, such as side effects of medicines and interactions with concomitant medications, can be made in detail.

A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

Lived experience of mothers who have child with cerebral palsy (뇌성마비아 어머니의 경험)

  • Lee Hwa Za;Kim Yee Soon;Lee Gee Won;Gwan Soo Za;Kang In Soon;An Hea Gyung
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.93-111
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    • 1996
  • The purpose of the study is to identify the lived experience of mothers who have children with cerebral palsy in order to understand their agony. Moreover, the result of study was to find some nursing intervention for disabled children and their mothers. For this purpose, ten mothers who are willing to cooperate with this research were selected at random from those who have children with the cerebral palsy, currently using the municipal facilities for the handicapped with cerebral malfunction. Data collection was done from October 4, 1994 th December 31, 1994. The data were collected by asking the mothers mentioned above with some unstructured open-ended questions, recorded on the tapes with permission by the interviewee in order to prevent missing of the interviewed contents. These collected data have been substantiated and properly analyzed on the basis of phenomenological approach initiated by Colaizzi's method. The results and validity are proved to be credible by means of the individual checking of the interviewed mothers. The results of this study are as follows : 1. When the mother is first informed of the diagnosis of cerebral palsy on her child, she usually misses the crucial timing needed for proper treatment of the child's disorder because she is notified through the doctor's indifference and his apparently inactive, matter-of-fact attitude. At first she suspects the doctor's diagnosis and tries to attribute it to the unknown cause from a certain genetic problem and then she quickly wants to deny the whole situation that her child is really suffering from the cerebral palsy. The reality is too much for her to accept as it is and she would not believe her child is abnormal. Therefore, she even attempts depend on the power of God for its solution. 2. The mother, who goes thorough this kind of uncommon experiences, is totally devoted to the treatment and care of the child and completely ignores her own life and happiness. At the same time, she feels sorry for her other normal children she believes having not enough care and concern. Also, she feels sorry for the sick child when the child's brothers or sisters show special concern for the patient out of sympathy. It is sorry and not satisfied for her that the child is growing with abnormality and neighbor other around have inappropriate attitudes. Likewise, she is discontent with her husband's lack of concern about the child's treatment. She believes that the health care system in this society isn't fulfilling its due purpose. In the state of her utmost distress and anxiety, she always feels the need of competent consultants, and is angry about that her child is treated as an abnormal being, she is trying to hide the child from other people and to make him or her disappear, if possible. Although she doesn't have harmonious relation with her husband, she id happy when he shows his affection for the child and she feels relieved and thankful when the relatives don't mention about the child's condition Since the child's overall status of health is continuously in unstable conditions, requiring her all-time readiness for an emergency, she feels guilty of her child's illness toward the fEmily members as if it was her own fault to have borne such an abnormal child and she feels responsible for the child morally and financially if necessary Because her life is centered on taking care of the child, she cannot afford to enjoy her own life and happiness. She is a lonely mother, fatigued, with no proper relationship with other people around her. With this sense of guilt and responsibility as a mother of an unusual disease, she has no choice but to grieve her destiny from which she is not allowed to escape. 3. Nevertheless, the mother with the child suffering from the cerebral palsy does not easily give up the hope of getting her child cured and she believes that in the long run, though slower than hoped, her abnormal son or daughter will be eventually cured to become a normal sibling someday. This kind of hope is sustained by the mother's strong faith coming from observing the progress of other similar children getting better. Sometimes she is encouraged to have this faith by other mothers who share the same painful experiences, believing that her child will improve even more rapidly than others with the same palsy. Full of hope, she painstakingly waits for the child's healing. Moreover, she plans to have another child. she thinks that the patient child's brothers and sisters only can truly understand and look after the patients. However, when she notices that the progress of other children under the treatment does not look so hopeful, she is distressed by the thoughts that her child may never get well. Too, she is worried that the patient's brother or sister will be born as the same invalid with the cerebral disease. She is discouraged to have another baby as much as she is encouraged to. She is also troubled by the thought that in case she has another baby, she will have to be forced. to neglect the patient child, especially when she does have an extra hand or some reliable person to help her with taking care of the patient.

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The Evaluation of the Difference of the SUV Caused by DFOV Change in PET/CT (PET/CT 검사에서 확대된 표시시야가 표준섭취계수에 미치는 영향 평가)

  • Kwak, In-Suk;Lee, Hyuk;Choi, Sung-Wook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.13-20
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    • 2011
  • Purpose: The limited FOV(Field of View) of CT (Computed Tomography) can cause truncation artifact at external DFOV (Display Field of View) in PET/CT image. In our study, we measured the difference of SUV and compared the influence affecting to the image reconstructed with the extended DFOV. Materials and Methods: NEMA 1994 PET Phantom was filled with $^{18}F$(FDG) of 5.3 kBq/mL and placed at the center of FOV. Phantom images were acquired through emission scan. Shift the phantom's location to the external edge of DFOV and images were acquired with same method. All of acquired data through each experiment were reconstructed with same method, DFOV was applied 50 cm and 70 cm respectively. Then ROI was set up on the emission image, performed the comparative analysis SUV. In the clinical test, patient group shown truncation artifact was selected. ROI was set up at the liver of patient's image and performed the comparative analysis SUV according to the change of DFOV. Results: The pixel size was increase from 3.91 mm to 5.47 mm according to the DFOV increment in the centered location phantom study. When extended DFOV was applied, $_{max}SUV$ of ROI was decreased from 1.49 to 1.35. In case of shifted the center of phantom location study, $_{max}SUV$ was decreased from 1.30 to 1.20. The $_{max}SUV$ was 1.51 at the truncated region in the extended DFOV. The difference of the $_{max}SUV$ was 25.9% higher at the outside of the truncated region than inside. When the extended DFOV was applied, $_{max}SUV$ was decreased from 3.38 to 3.13. Conclusion: When the extended DFOV was applied, $_{max}SUV$ decreasing phenomenon can cause pixel to pixel noise by increasing of pixel size. In this reason, $_{max}SUV$ was underestimated. Therefore, We should consider the underestimation of quantitative result in the whole image plane in case of patient study applied extended DFOV protocol. Consequently, the result of the quantitative analysis may show more higher than inside at the truncated region.

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A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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