• 재활치료과학
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• 제3권1호
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• pp.7-17
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• 2014

목적 : 본 연구에서는 참여(participation)를 종속변인으로 선정한 국내외의 논문들을 수집 분석하여 참여 평가에 대한 활용도를 알아보고자 하였다. 또한, 근래에 투고된 참여 논문들의 정보를 종합하여 참여 평가를 목적으로 사용한 평가도구 사용현황과 참여 증진을 위한 중재의 종류, 논문 별 목적, 대상자, 디자인 등을 분석하여 국내외의 참여연구의 현황을 확인하였다. 연구 방법 : 2004년부터 2013년 까지 최근 10년 사이의 논문을 대상으로 "Occupational Therapy<전문> AND stroke <제목> AND participation<제목>"을 주제어로 검색하였다. 국외 논문은 Pubmed를 이용하였고, 국내 논문은 국가전자 도서관, 국회도서관, 학술연구정보서비스를 통해 검색이 이루어졌다. 결과 : 선행연구의 고찰 결과, 총 12편의 논문이 사용되었으며 국외 논문은 11편, 국내 논문은 1편이 검색되었다. 참여수준 향상을 위한 중재는 2편의 논문에서 확인되었다. 가장 많이 쓰인 연구 디자인은 조사(survey)였으며 총 4개의 논문에서 설문지, 전화, 방문조사 등을 통해 이루어졌다. 평가도구는 총 21종류의 평가도구가 29회 사용되었다. 가장 빈번하게 사용된 평가도구는 Activity Card Sort(ACS)로 3회 사용되었다. 결론 : 국내외적으로 참여에 대한 연구는 매우 부족한 실정이며, 이는 변화된 현재 추세를 따라가지 못하는 처세이다. 앞으로는 뇌졸중 환자들의 보다 나은 삶을 위하여 신체적 기능 향상만이 아닌 참여 증진을 위한 연구가 보다 진행되어야 할 것이다.

• The Journal of Korean Physical Therapy
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• 제27권4호
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• pp.252-257
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• 2015

Purpose: The purpose of this study was to assess psychometric properties of the Korean version of the Stroke Impact Scale 3.0 (K-SIS 3.0) in patients with stroke. Methods: Patients with stroke longer than 3 months were invited to participate in the study at specialized rehabilitation centers in Busan. Information on patients was collected using Mini-Mental State Examination (MMSE), Modified Bathel Index (MBI), Beck Depression Index (BDI), WHODAS 2.0-12 item, and K-SIS. Floor and ceiling effects of each domain of K-SIS were examined. The internal consistency of each domain of the K-SIS was calculated using Cronbach's ${\alpha}$. Correlation between K-SIS and each scale was assessed using Spearman's correlation coefficient. Results: Ninety subjects participated in the study. The K-SIS was found to have excellent internal consistency (Cronbach's ${\alpha}=0.93$). Each domain of the consistency ranged from 0.86 to 0.94, except the emotion (${\alpha}=0.51$). Significant correlations were observed between MMSE and domains of memory and thinking, and communication (r=0.48 and 0.52 respectively). BDI was negatively related to domains of emotion, ADL, mobility, and participation (r=-0.43, -0.49, -0.52 and -0.33 respectively). Specific daily activity (MBI) and general functioning (WHODAS 2.0) were also found to be closely related to the domains of ADL, mobility, and participation (ranging from r=-0.41 to r=-0.59). No ceiling and floor effect was observed. Conclusion: Excellent reliability and validity of K-SIS were obtained in the study and it could be suggested that K-SIS may be used for patients with stroke for collection of information on functioning in the clinical context.

• Physical Therapy Rehabilitation Science
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• 제11권1호
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• pp.32-42
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• 2022

Objective: This study was conducted to verify the effectiveness of a cognitive rehabilitation program consisting of physical exercises and mental activities for patients with chronic stroke with mild cognitive impairment (MCI). We aimed to investigate how this cognitive rehabilitation program affects patients' cognitive ability, depression, and sleep quality. Design: One group pretest-posttest design Methods: The study was conductedon 12 patients who participated in thecognitive rehabilitation complex exercise program for 16 weeks. The Korean version of the Montreal Cognitive Assessment (MoCA-K), Hamilton Depression Rating Scale (K-HDRS), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the measured variables before and after study participation. The cognitive rehabilitation complex exercise program included 30 minutes of cognitive exercise and 30 minutes of Brill Exercise. The Wilcoxon signed-rank test was used to compare the variables before and after program participation. Cronbach's ɑ was used to assess the reliability of the test variables. Results: The post-program assessment showed a statistically significant increase in the MoCA-K score, which measures cognitive function (Z=-2.628, P=0.009). For depression ratings, there was a statistically significant decrease in the K-HDRS score (Z=-2.041, P=0.041). For sleep quality, although there was a numerical increase in the PSQI score, the difference was not statistically significant (Z=-0.702, P=0.483). The reliability test confirmed that all the individual test variables exhibited high reliability (cognitive function, 0.859; depression, 0.872; sleep, 0.822). Conclusions: We found that cognitive rehabilitation program used in this study had a positive effect on the cognitive function and depression in patients with chronic stroke with MCI.

• 성인간호학회지
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• 제22권2호
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• pp.113-120
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• 2010

Purpose: The purpose of this study is to examine the factors influencing the barriers faced by Korean nurses in addressing the patients' sexual health. Methods: The subjects in this study were nurses working at hospitals in Seoul and Jeonju. The data for this study were collected between November 2008 and December 2008. The subjects were assured of anonymity and confidentiality. Results: The barriers to addressing the patients' sexual health were moderate in the subjects. The nurses had moderate sexual knowledge and communication skills. In a stepwise regression analysis, the areas of work, communication skills, participation in sexual health training, and experience in Obstetrics and Gynecology accounted for 18.3% of the variance of the barrier for addressing the patients' sexual health. Conclusion: These findings emphasize the need for the development of a patient-centered sexual health-related curriculum for nurses, which has been briefly discussed in Korea. An educational program that improves the nurses' communication skills will be effective in reducing the barriers to addressing the patients' sexual health and will help the nurses become sexual health specialists.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7539-7545
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• 2014

Background: It has been proved that participating in exercise improves colorectal cancer patients' prognosis. This study is to identify barriers to exercise in Korean colorectal cancer patients and survivors. Materials and Methods: A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. Results: The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Conclusions: Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.

• Tuberculosis and Respiratory Diseases
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• 제86권2호
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• pp.133-141
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• 2023

Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Conclusion: Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

• 의료법학
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• 제15권1호
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• pp.211-237
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• 2014

Because of unpredictability and high possibility of abnormal results by clinical trials compared to general medical behaviors, a procedure for ensuring with sufficient explanations by investigators must be secured. Therefore, in a sequence of clinical trials, what kinds of scope, stage, and method of explanations provided by investigators, including doctors or researchers, to trial subjects are closely related to the compensation for damages by violation of liability for explanation. In case of application of clinical trials to patients who have critical illness such as cancer, issues of "Quality of Life" regarding trial subjects, cancer patients, should be discussed. Especially, in case of clinical trials for terminal cancer patients, the right of subjects' self-determination, which is a fundamental principle in medical behaviors, should be discussed. The right of self-determination includes participation in clinical trials for the possibility of life-sustaining even a little bit, or no participation in clinical trials in order to have a time for completing the rest of his life. Like this, if the extent and scope of explanations related to the issues of "Quality of Life" are raised as main issues, the evaluation of "Quality of Life", should be a prerequisite. In many occasions, realistically, despite bad results such as deaths or serious adverse drug reactions after clinical trials, it may not be easy for compensating to trial subjects or their survivors, who requested civil compensation for damage. Futhermore, in abnormal results after concealment of clinical trials or performance of clinical trials without permission, and in the case of trial subjects' failures of proving proximate cause between the clinical trials and abnormal results, problematic results such as no protection to the trial subjects could be occurred. In performing clinical trials, investigators should provide sufficient explanations for trial subjects and secure voluntary informed consents from the trial subjects. Therefore, clinical trials without trial subjects' permissions and the informed consent process violate trial subjects' rights of self-determination, and the investigators shall be liable for compensation for damages. Then, issues might be addressed are what are essential contents of patients' "rights of self-determination" infringed by clinical trials without subjects' permissions. Two perspectives about patients' rights of self-determination might be considered. One perspective regards physical distress of patients (subjects) from therapies without sufficient explanations as the crux of the matter. The other perspective regards infringement of human dignity caused by being subjects without permission as the crux of the matter irrespective of risks' big and small influences. This research follows perspective of the latter. Forming constant fiduciary relation between investigators (doctors) and subjects (patients) pursuant medical contracts, and in accordance with this fiduciary relation, subjects, who are patients, have expectations of explanations and treatments by the best ways. If doctors and patients set this forth as a premise, doctors should assume civil liability when doctors infringe patients' expectations.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6311-6316
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• 2015

Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.

• 한국융합학회논문지
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• 제12권9호
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• pp.361-371
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• 2021

본 연구의 목적은 공유의사결정과 의료진 신뢰 간의 관계에서 환자활성화의 조절효과를 규명하기 위함이다. 연구 대상은 대전광역시에 소재한 상급 종합병원 내분비대사내과에서 당뇨병 치료를 받고 연구 참여에 동의한 환자 186명이다. 연구결과, 의료진 신뢰(β=0.32, p=.045)와 환자활성화(β=0.32, p=.024)는 공유의사결정에 영향을 미치며, 의료진 신뢰와 공유의사결정 관계에서 환자활성화는 조절효과가 있는 것으로 나타났다(β=0.25, p=.019). 연구결과를 기반으로 공유의사결정의 활성화를 위해 환자의 의료진 신뢰 정도를 사정하여 의료진에 대한 부정적 인식을 개선하고, 신뢰를 강화할 필요가 있다. 또한 공유의사결정에 참여를 촉진하기 위한 환자활성화에 초점을 맞춘 융합적 프로그램을 개발하여 교육할 것을 제안한다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2829-2832
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• 2012

Background: This study aimed to research the awareness of screening colonoscopy (SC) among patients with colorectal cancer (CRC) and their relatives. Methodology: A questionnaire form including information and behavior about colonoscopic screening for CRCs of patients and their first-degree relatives (FDRs) was prepared. Results: A total of 406 CRC patients were enrolled into the study, with 1534 FDRs (siblings n: 1381 and parents n: 153). Positive family history for CRC was found in 12% of the study population. Previous SC was performed in 11% of patients with CRC. Mean age of the patients whose FDRs underwent SC was lower than the patients whose FDRs did not (52 vs 57 years; p<0,001). The frequency of SC in FDRs was 64% in patients diagnosed CRC under 35 years of age. Persons having a positive family history of CRC had SC more often (51 vs 22%, p<0,001). FDRs of patients having a higher educational level and income had SC more frequently. Conclusions: When screening for CRC is planned, elderly subjects, those with family history for CRC, and those with low educational and lower income should be given esspecial attention in order that they be convinced to undergo screening for CRC.