This study was conducted to construct and test a structural equation model of instrumental activities of daily living(IADL) in community-dwelling elderly. The model was based on ICF(International Classification of Functioning, Disability and Health) model. The participants were 260 elderly who were more than 65 years old. Physical and psychological function, visual-motor integration and social activities had direct effects on IADL. That is, the better the subjective health status, the lower the depression and the less chronic illness, the better IADL. Personal factor, social support and social activities had indirect effect on IADL. This model explained 32% of the variance in IADL.
Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.
Objective: To illustrate effects and application potential of Mirror Therapy (MT) for patients with post-stroke hemiplegia. Method: With reference to 9 journals (published Jan.2005-Jan.2016) on Pubmed, selected based on in/exclusion standards. Result: Simple wrist/hand movements and task-based MT were used as intervention methods to examine the effects. Tools used to assess intervention effects included upper limb functioning, Activities of Daily Living (ADL), physical condition and quality of life. Upper limb functioning turned out to have significance for ADL with higher effectiveness at the distal than the proximal region. Yet the quality of life disparity between the experiment group and the control was not found to be significant. Conclusion: We believe that research can aid clinical therapists in applying MT accordingly to individual patient characteristics. Despite prolonged difficulty in confirming efficient application due to varied protocols, development of systemized treatment protocols for maximization of MT's effectiveness remains necessary.
Purpose: Electrogastrography is a method of measuring action potentials of the stomach. The purpose of this study was to investigate early postoperative changes in the electrogastrography and determine the correlation between electrogastrography and quality of life of patients with stomach cancer who underwent distal gastrectomy. Materials and Methods: This study analyzed 20 patients with stomach cancer who underwent electrogastrography and quality of life was measured 1, 12, and 24 weeks after the operation. Quality of life-C30 version 3.0 and quality of life-STO22, were used. Results: Fasting and postprandial mean dominant frequency at 1 week after the operation was 2.7 and 2.7 cycles per minute, and 2.8 and 2.7 cycles per minute at 12 weeks, 2.6 and 2.8 cycles per minute at 24 weeks. Fasting and postprandial mean dominant power at 1 week was 36.5 and 36.4 dB, 36.3 and 40.1 dB at 12 weeks and 40.9 and 42.3 dB at 24 weeks. The percentage of tachygastria was increased whereas the percentage of bradygradia was decreased during the postoperative periods (P<0.05). Global health, physical, emotional and social functioning scales were improved, but role and cognitive functioning were not changed. Pain, insomnia, diarrhea and financial difficulties were significantly improved according to the postoperative periods (P<0.05). The correlation between the STO22 and electrogastrography parameters was not significant (P>0.05). Conclusions: These may suggest that electrogastrography is a simple and noninvasive method and may be applicated for evaluating motility and autonomic functions of the remnant stomach.
Jin, Ju Hyun;Yoon, Shin Won;Song, Jungeun;Kim, Seong Woo;Chung, Hee Jung
Clinical and Experimental Pediatrics
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v.63
no.6
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pp.219-225
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2020
Background: There is increasing concern that moderate preterm (32-33 weeks' gestation) and late preterm (34-36 weeks' gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance. Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at school age in moderate to late preterm infants. Methods: Children aged 7-10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires. Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes. Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.
Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc herniation according to the duration by treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : We separated 36 patients with disc herniation into three group according to duration; acute patients within 4 week, subacute patients within 5-12 week, and chronic group within 13-24 week. 36 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients' symptoms were assessed 1 week, 2 week, 4 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. ODI of disability of daily activities showed significantly decreased in acute stage group compared to subacute and chronic stage groups(P<0.05). 2. Physical functioning(PF), bodily pain(BP), social functioning(SF) score of SF-36 showed significantly increased in acute stage group compared to subacute and chronic stage groups(P<0.05). Conclusions : This study suggests that acute stage group compared to subacute and chronic stage groups in patients with lumbar disc herniation is the more effective to improve symptoms treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.
Purpose: Children treated for Hirschsprung disease (HD) are adversely affected by fecal incontinence and soiling. This can be detrimental to their physical, psychosocial quality of life (QoL) and impacts the normal functioning of their family. QoL studies in HD are predominantly from developed countries. We measured general quality of life, impact on family and functional bowel status using validated questionnaires in HD children in a developing country. Methods: Patients with HD, treated in a tertiary paediatric institution in India between 2010 and 2017, were identified. Patients and/or their proxy completed the Pediatric Quality of Life and Family Impact Module questionnaires. Functional outcomes were assessed using Rintala's score. Results: A 86 children and their parents participated in the study. Majority had rectosigmoid disease (67.4%) and underwent Soave's endoanal pull through (74.4%). A 21% of patients had low Rintala score indicating poor functional bowel outcomes. Only 11% of children had poor QoL scores. Family functioning outcomes were also severely affected in the same subgroup of patients. There was statistically significant correlation between Rintala score and QoL scores (p-value<0.001). Disease severity, type of surgery, and duration of follow-up did not have a statistically significant impact on the QoL. Conclusion: QoL in children with HD was comparable to the general population. Bowel dysfunction affects a notable number of children and was the most significant determinant of poor QoL.
Journal of the Korean society of biological therapies in psychiatry
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v.24
no.3
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pp.218-229
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2018
Objectives : Antipsychotic-induced hyperprolactinemia causes physical symptoms, such as amenorrhea, galactorrhea, gynecomastia, sexual dysfunction, and bone density loss, as well as psychiatric symptoms, such as depression and cognitive impairments. This study aimed to clarify the associations among hyperprolactinemia caused by antipsychotics in patients with schizophrenia, psychiatric pathology, and psychosocial factors. Methods : Ninety-nine patients with schizophrenia in the psychiatry department of a university hospital were registered between 2015 and 2017. All participants were assessed using structured questionnaires to elucidate psychopathology, social function, quality of life, and hyperprolactinemia-related side effects. The standard levels for hyperprolactinemia were 24ng/mL for women and 20ng/mL for men. Results : The average prolactin levels were $73.45{\pm}49.37ng/mL$ in patients with hyperprolactinemia and $9.16{\pm}6.42ng/mL$ in those without hyperprolactinemia. The average prolactin level in women was significantly higher than that in men(p=0.04). Risperidone was most commonly administered in patients with hyperprolactinemia(58.1%, p<0.01), while aripiprazole was most commonly administered in those without hyperprolactinemia(44.7%, p<0.01). Patients with hyperprolactinemia had significantly higher Positive and Negative Syndrome Scale(p=0.03) and Patient Health Questionnaire-9(p=0.05) scores and had significantly lower Social and Occupational Functioning Assessment Scale(p=0.04) and Strauss-Carpenter Levels of Functioning Scale(p=0.03) scores than patients without hyperprolactinemia. There were no significant differences in side effects or quality of life between the two groups. Conclusion : These findings demonstrate that hyperprolactinemia confers negative effects on depression and social function, but does not directly affect the quality of life. These results suggest that patients with schizophrenia who take antipsychotics that increase prolactin or cause side effects of hyperprolactinemia need to be assessed and receive interventions for depression.
Background: This study was planned to investigate the relationship between musculoskeletal problems, depression, and quality of life in students preparing for university entrance exams. Methods: A total of 180 students were included in the study, 104 were female (57.77%), and 76 were male (42.22%). Students were reached through the cram schools ("dershane") in Denizli. Musculoskeletal system problems, depression status, and quality of life were determined with the Musculoskeletal-Postural Discomfort Scale (MDS), Boratav Depression Screen Scale (Bordepta), and Short Form-36 (SF-36), respectively. Demographic data, daily study, and sleep duration were also recorded. Results: Students have moderate musculoskeletal discomfort. Musculoskeletal disorders and depressive symptoms are more observed in female students than male students (P = 0.000). The SF-36 results were significantly negatively correlated with the MDS and Bordepta scores. A significant positive correlation was found between musculoskeletal disorders and depression status (r = 0.351, P = 0.000). Sleep duration was negatively correlated with the MDS and Bordepta (r = -0.209, P = 0.005; r = -0.148, P = 0.047, respectively) and positively correlated with the SF-36 role limitation/emotional and social functioning subscales (r = 0.225, P = 0.002 and r = 0.191, P = 0.010 respectively). Conclusions: Musculoskeletal problems and depression status negatively affects general health status especially in female students who are preparing for university entrance examinations. Students should be informed about musculoskeletal problems by healthcare professionals and the study room, tables, and chairs should be arranged ergonomically. Further studies might be determined that why musculoskeletal disorders and depression status are more widely among female students.
Purpose: The purpose of this study was to analyze the weight bearing of the cane and foot for the different walking aids during walking. Methods: A total of 12 subjects (6 males, 6 female) with stroke were enrolled in the study. Foot sensor and an instrumented cane were integrated to analyze the vertical peak force on the foot and cane. Results: The vertical peak force applied on the quad cane gait resulted in a significantly higher rate, which was $10.60{\pm}6.48%$ of the body weight, when compared to that of mono cane gait which was $7.91{\pm}4.11%$. The results indicated significantly lower vertical peak force on the affected foot, without the help of a walking aid, as compared to that of walking with a cane (respectively, p<0.05). However, results showed that the differences in vertical peak force on the affected foot, between mono cane and quad cane, were not significant. Conclusion: In conclusion, the vertical peak forces were significantly greater, during a comparison between walking with a quad cane and walking with a mono cane. On the contrary, no significant difference in the vertical peak force on the affected foot between walking with quad cane and walking with a mono cane. Muscle activation pattern and walking pattern should be measured in future studies, to study the differences between walking with various walking aids in the lower and higher functioning hemiparetic subjects, as its use may mask underlying gait impairment.
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