• Research in Community and Public Health Nursing
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• v.29 no.4
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• pp.429-439
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• 2018

Purpose: The aim of this study is to identify core keyword of frailty research in the past 35 years to understand the structure of knowledge of frailty. Methods: 10,367 frailty articles published between 1981 and April 2016 were retrieved from Web of Science. Keywords from these articles were extracted using Bibexcel and social network analysis was conducted with the occurrence network using NetMiner program. Results: The top five keywords with a high frequency of occurrence include 'disability', 'nursing home', 'sarcopenia', 'exercise', and 'dementia'. Keywords were classified by subheadings of MeSH and the majority of them were included under the healthcare and physical dimensions. The degree centralities of the keywords were arranged in the order of 'long term care' (0.55), 'gait' (0.42), 'physical activity' (0.42), 'quality of life' (0.42), and 'physical performance' (0.38). The betweenness centralities of the keywords were listed in the order of depression' (0.32), 'quality of life' (0.28), 'home care' (0.28), 'geriatric assessment' (0.28), and 'fall' (0.27). The cluster analysis shows that the frailty research field is divided into seven clusters: aging, sarcopenia, inflammation, mortality, frailty index, older people, and physical activity. Conclusion: After reviewing previous research in the 35 years, it has been found that only physical frailty and frailty related to medicine have been emphasized. Further research in psychological, cognitive, social, and environmental frailty is needed to understand frailty in a multifaceted and integrative manner.

• Health Policy and Management
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• v.18 no.4
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• pp.1-22
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• 2008

Burden of disease analysis provides a unique perspective on health by integrating fatal and non-fatal outcomes, yet allows the outcome of two classes to be examined separately. Although many studies have shown the inequality in health outcomes across socioeconomic status (SES), an analysis and comparison of Disability Adjusted Life Year (DALY) between different socioeconomic groups has been rare. This paper calculates the DALY and analyzes the distribution of DALYs for different SES. This study draws from 3,278 cases from the survey on "The Livelihood and Welfare Needs of the Elderly (2004)". It first provides a comprehensive assessment of the burden of 10 chronic diseases of the elderly based on DALY. Then this paper analyzes inequalities in the burden of disease by the levels of SES such as education, income, family size, occupation, and subjective economic conditions. For the elderly, the burden of disease is the highest for hypertension, arthritis and cancer. DALY rate per 1,000 people for the most socio-economically disadvantaged group is expressed as a multiple of the standardized rate for the least disadvantaged group (Rate Ratios). Family size is strongly related to. the difference in the burden of disease between SES groups, and the elderly Who live alone have higher DALY rate than those who live with their family. Other significant variables related to SES groups include subjective economic conditions, occupation, elderly income, and household income.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.484-492
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• 2006

Purpose: The purpose of this study was to investigate the effects of a rehabilitation nursing program(RNP) for persons with disabilities. Method: a quasi-experimental pretest and post test study was used to examine the changes of patient's muscle strength, flexibility, self efficacy and health related quality of life at the completion of an 8-week education and physical exercise with a Thera-Band and Exercise Ball course. The subjects consisted of 40 adults who were disabled. Twenty-two experimental and 18 control subjects completed pre and post-test measures. Outcome variables were flexibility, hand grip, elbow flexor and extensor, knee flexor and extensor, self efficacy and quality of life. Independent t-test and ANCOVA were used to examine group differences by using SPSS 12.0 Result: Mean comparisons of the change scores revealed that the experimental group increased significantly in knee extremity flexor(p=0.035), extensor(p=0.039), flexibility(p=0.008), self efficacy(p=0.000), and quality of life(p=0.000). No significant group differences were found in each patient's hand grip, elbow flexor and extensor. Conclusion: RNP can improve lower extremity flexibility, muscle strength, self efficacy and health related quality of life in people with disabilities. The intervention to tailor exercise and education to the unique needs of the disability was suggested for further study.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.147-159
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• 2020

Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data. Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling. Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days. Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.

• Physical Therapy Korea
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• v.17 no.3
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• pp.59-67
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• 2010

Mortality rates from stroke have been declining. Because of this, more people are living with residual disability. Rehabilitation plays an important role in functional recovery of stroke survivors. In stroke rehabilitation, early prediction of the obtainable level of functional recovery is desirable to deliver efficient care, set realistic goals, and provide appropriate discharge planning. The purpose of this study was to identify predictors of functional outcome after stroke using inpatient rehabilitation as measured by Functional Independence Measure (FIM) total scores. Correlation and stepwise multiple regression analyses were performed on data collected retrospectively from two-hundred thirty-five patients. More than moderate correlation was found between FIM total scores at the time of hospital admission and FIM total scores at the time of discharge from the hospital. Significant predictors of FIM at the time of discharge were FIM total scores at the time of hospital admission, age, and onset-admission interval. The equation was as follows: expected discharge FIM total score = $76.12+.62{\times}$(admission FIM total score)-$.38{\times}(age)-.15{\times}$(onset-admission interval). These findings suggest that FIM total scores at the time of hospital admission, age, and onset-admission interval are important determinants of functional outcome.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.1
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• pp.136-146
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• 2009

Purpose: The purpose of this study was to investigate the effects of copayments for doctor visits and prescription drugs on health services utilization in the Type I Medicaid beneficiaries in Korea. Method: This study examined data from the 2007 survey on Health Services Use and Health Status of Medicaid Beneficiaries performed by the Ministry for Health Welfare and Family Affairs. To analyze these sample survey data, the SURVEYFREQ, SURVEYMEANS, and SURVEYREG procedures which incorporate the sample design into the analyses were used. Results: Findings of this study indicate that copayments for doctor visits and prescription drugs of Medicaid Type I beneficiaries have cut overall medical costs. However, although results should be interpreted very carefully because of the relatively low $R^2$, copayments have cut more health services utilization of people who need more health services because of their complex diseases and disability. In addition, besides copayment, several factors are affecting differences in health services utilization before and after copayments implementation. Conclusion: These results highlight the need to examine the effects of copayments more thoroughly according to the kinds of disease, the severity of disease, and the level of copayment.

• Journal of the Korean Society of School Health
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• v.18 no.2
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• pp.85-92
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• 2005

Purpose： This study reviews the Youth Risk Behavior Surveillance System (YRBSS) in the United States. This review focuses on the purposes, questionnaires, survey methods, and use of survey results. The author also discussesthe establishment and use of Korean Youth Risk Behavior Surveillance System. Results：The YRBSS was developed in 1990 to monitor priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The purpose of YRBSS is to determine the prevalence of health risk behaviors, to assess the trend of health risk behavior prevalence, provide comparable data, monitor progress toward achieving the Healthy People 2010. The questionnaires inquire about health-related behaviors, including tobacco use, unhealthydietary behaviors, inadequate physical activity, alcohol and drug use, sexual activity, behaviors that contribute to unintentional injuries and violence. The results of YRBS have been used to estimate the prevalence of risk behaviors among youth, to set goals for school health programs, for training and development of health program personnel, for the development of health education curriculum, to support enactment of health-related regulations, and to support funding for futher research. Conclusions： The YRBSS represents a potentially valuable program that can be applied in Korea. Assessment of risk behaviors among Korean youths will provide invaluable insight for many potential purposes.

• Human Ecology Research
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• v.57 no.3
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• pp.445-457
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• 2019

This study investigated the impact of parentification on ambivalence over the emotional expression of early adults who had a sibling with disabilities and examined if rejection sensitivity moderated the relationship of parentification and ambivalence over emotional expression. Participants consisted of 116 siblings in early adulthood who had a sibling with disabilities (45 male; 71 female). The data were collected from 13 centers for family disability, four community rehabilitation centers, three parent societies for people with disabilities, and three self-help groups in Seoul, Busan, and Gyeonggi province. The levels of ambivalence over emotional expression, parentification, and rejecton sensitivity were measured by the Ambivalence over Emotional Expression Questionnaire (King & Emmons, 1990), the Filial Responsibility Scale-Adult (Jurkovic, Thirkield, & Morrell, 2001), and the Rejection Sensitivity Questionnaire (Downey & Feldman, 1996), respectively. The PROCESS Macro program examined the moderating model. The Results indicated that both levels of parentification and rejection sensitivity increased the level of ambivalence over emotional expression of non-disabled siblings. In addition, rejection sensitivity moderated the effect of parentification on ambivalence over emotional expression. The influence of parentification on ambivalence over emotional expression was greater when the level of rejection sensitivity was high, compared to when it was low.

• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.10-15
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• 2013

Purpose: Low back pain occurs and frequently recurs in many people. An imbalance of paraspinal muscle activity can cause low back pain. Mulligan's concept of mobilizations with sustained natural apophyseal glides (SNAG) is a common method for treating low back pain. The purpose of this study was to investigate the effects of this method on paraspinal muscle activity in patients with chronic low back pain. Methods: Twenty-one patients with low back pain participated in this study. Patients were classified using the Oswestry disability index. The subjects' paraspinal muscles were measured by surface electromyography both before and after the SNAG mobilization. We measured the root mean square value of the paraspinal muscles during lumbar flexion and extension. Results: Paraspinal muscle activity in patients with chronic low back pain was different between the right and left sides. Importantly, paraspinal muscle activity significantly decreased after using the SNAG mobilization method. Conclusion: This study shows a difference between paraspinal muscle activity in chronic low back pain patients and finds that the Mulligan's concept of SNAG mobilization is effective at reducing imbalances in paraspinal muscle activity in low back pain patients.

• Physical Therapy Korea
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• v.9 no.2
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• pp.19-32
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• 2002

The purpose of this paper is to provide the reader with a pertinent information and research trends of biomechanics in wheelchair propulsion. Biomechanical studies for wheelchair propulsion mainly focus on the most suitable propulsion performance and methods for preventing upper extremity injuries. Recent issues have concentrated on wheelchair propulsion style and cycle mainly because of the high prevalence of repetitive strain injuries in the upper extremely such as shoulder impingement and carpel tunnel syndrome. Optimizing wheelchair propulsion performances as well as medical reflections are presented throughout the review. Information on the underlying musculoskeletal mechanisms of wheelchair propulsion has been introduced through a combination of data collection under experimental conditions and a more fundamental mathematical modelling approach. Through a synchronized analysis of the movement pattern and muscular activity pattern, insight has been gained in the wheelchair propulsion dynamics of people with a different level of disability (various level of physical activity and functional potential). Through mathematical modelling simulation, and optimization (minimizing injury and maximizing performance), underlying musculoskeletal mechanisms during Wheelchair propulsion is investigated.