• Title/Summary/Keyword: Rehabilitation service

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Characteristics of Patients who Died by Suicide in a Community Mental Health Center (정신건강센터 등록 회원 자살사망자 특성)

  • Nah, Gihoi;Choi, Seunggi;Kim, Honey;Lee, Ju-Yeon;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang;Kim, Sung-Wan
    • Korean Journal of Schizophrenia Research
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    • v.20 no.2
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    • pp.55-60
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    • 2017
  • Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

Survey on the Needs of Korean Medicine Doctor for Community Care Education Programs (한의약 건강돌봄 교육 프로그램에 대한 한의사 요구도 조사)

  • Jihye Kang;Eunji Ahn;Jihyeon Lee;Dongmin Sung;Yujin Han;Dongsu Kim
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.1-11
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    • 2024
  • Objectives : This study conducted a survey on the needs of Korean medicine doctors for health care education programs specializing in traditional Korean medicine. Methods : The study selected Korean medicine doctors who had experience participating in outpatient consultations. Data collected through surveys underwent frequency analysis on performance, importance, difficulty, and educational needs using SPSS 24.0. Additionally, an Importance-Performance Analysis (IPA) was conducted using importance and performance data. Results : According to the results of the IPA analysis, in the area of "keep up the good work" there were activities such as fee Claims (A3), comprehensive assessment (B4), care plan development (B5), client and caregiver interviews (C8), chronic disease monitoring (C9), musculoskeletal and other pain management, musculoskeletal rehabilitation (C10), mental health management (C11), and fall prevention (C15). In the "concentrate here" priority action area, skin care including pressure sore management (C13) was identified. Conclusions : The traditional Korean medicine community care service is expected to expand further, so it is anticipated that the developed educational programs will contribute to the activation of traditional Korean medicine health care business.

Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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The Effect of Virtual Reality Programs on Upper Extremity Function in Stroke Patients : A Meta-Analysis (뇌졸중 환자의 가상현실 프로그램이 상지기능에 미치는 영향 : 메타분석)

  • Cho, Sung-Hyoun;Choi, Ki-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.429-439
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    • 2020
  • This study examined the effect size of virtual reality programs on the upper extremity function of stroke patients through a meta-analysis. Databases, such as the Research Information Sharing Service, the Korean Studies Information Service System, the National Library of Korea, the Korean Citation Index, and the National Digital Science Library, were used. Previous articles were surveyed for virtual reality programs between January 2010 and June 2019. A meta-analysis was performed by selecting the final 14 studies based on the PICO standard. The RoB and RoBANS tools were used as quality assessment tools for randomized and non-randomized control trials, respectively. The CMA 3.0 program was used to calculate the effect size of each study. Sub-group analysis, meta-regression analysis, and publication bias were performed. The total effect size of the virtual reality programs on the upper extremity function was Hedges's g=0.390 (95% CI: 0.192~0.587) (p<.05). The virtual reality program positively affects the upper extremity function of stroke patients. Therefore, the development of various virtual reality programs and industry-academia cooperation technology for stroke patients is required in accordance with the fourth industry. Randomized control trials and detailed upper extremity function studies for virtual reality programs will be needed in follow-up studies.

Reliability and Validity of the Korean Version of SERVPERF : A Validation Study (서비스 질 척도(서브퍼프)의 타당화 연구: 종합사회복지관을 대상으로)

  • Kim, Yong-Seok;Choi, Jong-Bog;Hwang, Seong-Hye;Kim, Min-Suk;Seo, In-Ja
    • Korean Journal of Social Welfare
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    • v.61 no.2
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    • pp.107-135
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    • 2009
  • The purpose of this study is to develop and evaluate the Korean version of the SERVPERF which has been widely used in order to measure service quality in various kinds of fields including social work. A total of 328 adults using social welfare centers in Seoul and Gyeonggi-do participated in this study. Confirmatory factor analysis confirmed that the Korean version of the SERVPERF consists of 5 dimensions(tangibles, reliability, responsiveness, assurance, and empathy) like the original SERVPERF. 5 dimensions of the Korean version of the SERVPERF have acceptable levels of internal consistency. Its convergent validity and discriminant validity are satisfactory. Finally, weak or non-significant correlations between 5 dimensions of the Korean version of the SERVPERF and social desirability scale indicated that the participants' reponses to the Korean version of the SERVPERF were not affected by social desirability.

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Analysis of Occupational Therapy Intervention Research for Improving Memory: Focus on Single-Subject Research Design in Korean Academic Journals (기억력 향상을 위한 작업치료 중재 연구 분석: 국내 단일대상연구 중심으로)

  • Jung, Yu-Jin;Choi, Yoo-Im
    • Therapeutic Science for Rehabilitation
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    • v.10 no.4
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    • pp.39-52
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    • 2021
  • Objective : This study aimed to identify the characteristics and analyze the quality of studies on memory improvement using a single-subject research design. Methods : Six studies were selected through the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and National Digital Science Library (NDSL). Keywords were memory training, stroke, early dementia, mild cognitive impairment, and single-subject research design. The characteristics and quality levels were analyzed between January 2011 and October 2020. Results : Regarding the quality level, the middle level (7-10 points) was 66.7% of the four articles, and the high level (11-14 points) was 33.3% of the two articles. Reversal designs were used in all studies. Independent variables were errorless learning, smartphone application, cognitive training system (CoTras), spaced retrieval training (SRT) with errorless learning, spaced retrieval training, and iPad applications. The dependent variables included memory, attention, electroencephalogram, instrumental activities of daily living, depression etc., which increased after the intervention. The total session, study period, and intervention time were varied. Conclusion : In single-subject research design related to memory training, occupational therapy intervention was confirmed as an effective method for improving memory and attention. The quality level of single-subject research design was moderate or higher, and high-quality level of studies should be conducted by additional design to increase the validity in the future.

Association Between Lifestyle and Medical Expenses of Older Adults With Mental Illness: Using Korea Older Adults' Cohort Database (노인 코호트 DB를 이용한 정신과 질환 동반 노인의 생활 습관과 의료비 지출 크기의 연관성 분석 연구)

  • Jeong, Jiin;Bae, Suyeong;Yoo, Eun-Young;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.1
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    • pp.51-63
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    • 2023
  • Objective : This study aimed to analyze the association between lifestyle and medical expenses of older adults with mental illness using claims data. Methods : We conducted secondary data analysis using the older adult cohort database provided by the Korea National Health Insurance Service. The lifestyle and medical expense variables were extracted from the cohort database. We used a generalized linear model to examine the association between lifestyle and medical expenses. Results : In total, 32,853 records were extracted. The results showed that smokers had medical expenses (estimate = -218,255, p = .037). As the number of days of walking increased, medical expenses significantly decreased (estimate = -58,843, p < .0001). Furthermore, as the number of days of drinking decreased, medical expenses increased (estimate = 692,289, p < .0001). Conclusion : This study analyzed the estimates of medical expenses according to lifestyle among older adults with mental illness. Smoking and exercise were negatively associated with medical expenses. These results suggest the importance of a healthy lifestyle for older adults with mental illness. In addition, this study can be used as clinical evidence for lifestyle management programs to improve physical and mental health.

Present Conditions of Mental Health Care in Rural Areas: Community Mental Health Program of Public Health Center (농촌지역 정신보건관리실태: 보건소 지역사회정신보건사업)

  • Lee, Weon-Young;Kim, Dong-Moon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.1-14
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    • 2003
  • Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

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Cross-cultural Adaptation and Psychometric Evaluation of the Korean Version of the A-ONE (한국판 일상생활활동중심 작업기반 신경행동평가(A-ONE)의 개발 및 평가)

  • Kang, Jaewon;Park, Hae Yean;Kim, Jung-Ran;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.109-128
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    • 2021
  • Objective : The purpose of this study was to develop a Korean version of the Activities of Daily Living (ADL)-focused Occupation-Based Neurobehavioral Evaluation (A-ONE) through cross-cultural adaptation and examine its validity and reliability. Methods : This study translated the A-ONE into Korean and performed cross-cultural adaptation for the Korean population. After the development of the Korean version of the A-ONE, cross-cultural and concurrent validities were analyzed. Internal consistency, test-retest reliability, and inter-rater reliability were also evaluated. Results : We adapted three items to the Korean culture. The Korean version of the A-ONE showed high cross-cultural validity with a content validity index (I-CVI) >0.9. It correlated with the Functional Independence Measure (FIM) (r=0.52-0.77, p<0.001), except for communication. Cronbach's α was 0.58-0.93 for the functional independence scale (FI) and 0.42-0.93 for the neurobehavioral specific impairment subscale (NBSIS). Intraclass correlation coefficients (ICCs) indicated high test-retest and inter-rater reliability for FI (ICC=0.79-1.00 and 0.75-1.00, respectively) and NBSIS (ICC=0.74-1.00 and 0.72-1.00, respectively). Conclusion : The Korean version of the A-ONE is well adapted to the Korean culture and has good validity and reliability. It is recommended to evaluate ADL performance skills and neurobehavioral impairments simultaneously in Korea.

Behavior of Hollow Box Girder Using Unbonded Compressive Pre-stressing (비부착 압축 프리스트레싱을 도입한 중공박스 거더의 거동)

  • Kim, Sung Bae;Kim, Jang-Ho Jay;Kim, Tae Kyun;Eoh, Cheol Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.3A
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    • pp.201-209
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    • 2010
  • Generally, PSC girder bridge uses total gross cross section to resist applied loads unlike reinforced concrete member. Also, it is used as short and middle span (less than 30 m) bridges due to advantages such as ease of design and construction, reduction of cost, and convenience of maintenance. But, due to recent increased public interests for environmental friendly and appearance appealing bridges all over the world, the demands for longer span bridges have been continuously increasing. This trend is shown not only in ordinary long span bridge types such as cable supported bridges but also in PSC girder bridges. In order to meet the increasing demands for new type of long span bridges, PSC hollow box girder with H-type steel as compression reinforcements is developed for bridge with a single span of more than 50 m. The developed PSC girder applies compressive prestressing at H-type compression reinforcements using unbonded PS tendon. The purpose of compressive prestressing is to recover plastic displacement of PSC girder after long term service by releasing the prestressing. The static test composed of 4 different stages in 3-point bending test is performed to verify safety of the bridge. First stage loading is applied until tensile cracks form. Then in second stage, the load is removed and the girder is unloaded. In third stage, after removal of loading, recovery of remaining plastic deformation is verified as the compressive prestressing is removed at H-type reinforcements. Then, in fourth stage, loading is continued until the girder fails. The experimental results showed that the first crack occurs at 1,615 kN with a corresponding displacement of 187.0 mm. The introduction of the additional compressive stress in the lower part of the girder from the removal of unbonded compressive prestressing of the H-type steel showed a capacity improvement of about 60% (7.7 mm) recovery of the residual deformation (18.7 mm) that occurred from load increase. By using prestressed H-type steel as compression reinforcements in the upper part of cross section, repair and rehabilitation of PSC girders are relatively easy, and the cost of maintenance is expected to decrease.