• Title/Summary/Keyword: Walking-Assistance

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Effects of Low-intensity Exercise on Functional Ability in Hospitalized Elderly (저강도 운동프로그램이 입원노인의 일상활동 기능회복에 미치는 영향)

  • ;;;;Beverly L. Roberts
    • Journal of Korean Academy of Nursing
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    • v.27 no.4
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    • pp.807-819
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    • 1997
  • The purpose of the study was to identify the effects of a 12-week low-intensity exercise program on muscle strength, flexibility, balance, and cognitive characteristics related to the performance of activity of daily living(ADL). A total of 16 patients who were admitted to the medical unit of a general hospital in ChoongChung province were recruited, eight for the exercise group and eight for the comparison group. Four levels of low-intensity exercise from 'ROM on bed' to 'exercise while walking' were then applied to the exercise group according to their physical condition. During hospitalization, patients in the exercise group performed each level of the prescribed exercise with the researchers until they felt comfortable doing it independently. The researchers also visited the patients' homes after discharge to make sure they could perform the exercise with Theraband in their living environment. The exercise group was contacted by phone once a week to assess the frequency and intensity in which they performed the exercise as well as their physical condition. The subjects in the comparison group participated in measurements for the study without performing the exercise and were contacted by phone after discharge, in a matched time frame with the exercise group, to assess physical condition. Muscle strength, flexibility, balance, cognitive characteristics, and performance of ADL for the two groups were compared at the pretest and the posttest after the low-intensity exercise program by utilizing SPSSWIN and the results are as follows : 1) At the postest, measurements of muscle strengths showed that the strength of the dorsal flexor in the exercise group was significantly higher than in the comparison group. 2) Objective balance for the exercise group was significantly better than for the comparison group as measured by 'standing on one foot' and Tinetti gait and balance control. 3) The exercise group showed significantly higher task self-efficacy than the comparison group. 4) Perceived exertion for ADL for the exercise group was significantly lower than for the comparison group. 5) Improvement of performance of ADL without assistance was significantly higher for the exercise group than the comparison group. The findings suggest that a low-intensity exercise program would be useful for the elderly who show decline in their physical functioning due to hospitalization by partly improving physical strength, task self-efficacy, and performance of ADL. Directions for further research on issues of motivating people to exercise as well as of standardizing various types of exercise were discussed.

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The Health and Dietary management of Impaired elderly by ADL in Gyeonggi, Korea (ADL에 의한 도움필요 노인의 건강과 식생활관리 -경기지역 농촌노인을 중심으로-)

  • Rhie Seung-Gyo;Choi Mi-Yong;Won Hyang-Rye
    • The Korean Journal of Community Living Science
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    • v.17 no.3
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    • pp.159-174
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    • 2006
  • The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.

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A Study of the Nursing Needs of Hospitalized medical Patients by Means of Nursing History Form (간호력(Nursing History)을 통해 본 내과 입원환자의 간호요구)

  • 전경애
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.1-10
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    • 1977
  • Personalized Patient centered nursing care is increasingly difficult to achieve despite the fact that it remains one of our consistent goals. So, we must find away to individualized nursing care. One means, to achieve this is by use of the nursing history form, which has been developed to help the nurse make maximum use of her limited time with the patient, by obtaining systematically the information needed to plan his nursing care. The nursing history form can be used to collect data about individual nursing needs but also it lends itself to the collection of epidemiological data relevant to the needs of patient population. So this study was undertaken in an attempt to describe the general characteristics of the population studied, to find out their perceptions and expectations related to their illness and hospitalization, to find out specific basic needs and to examine the relationship between the patients nursing needs and demographic characteristics through the responses to the nursing history questions. The study population defined and selected was all the patients (70) who were admitted to Yonsei University Hospital from October 1 - 15, 1975. The direct interview method was used and the data were categorized by the investigator, according to the nature of responses to each question and were subjected to the percentile and the chi- square tests. The findings can be summarized as follows 11. General characteristics of the study population ; The population was made up mainly of urban patients who were highly educated. The age was equally distributed. 2. Patients, perceptions and expectations related to illness and hospitalization ; 88.6% of the patients knew about the reason for hospitalization but 64. 5% could state symptoms only. 37.5% recognized the cause of illness. Approximately three fourth of the patients expressed on expectation for early recovery. 60.0% of the patient responses indicated, that they expected less than 10 days of hospitalization. Of the total responses regarding hospitalization, 45.7% were negative about the post -hospitalization expectation, 45.7% expected to return to work. As a result of these findings, we can see that there is a great educational need, a psychological need and environmental need for adaptation to the hospital and a socio- economic need for the post - hospitalization period. 3. Specific basic needs : The physical needs include the problem of getting sufficient sleep (50.0%), difficulty in food intake(47.1%), problems with hospital diet (47.0%), abnormal condition of the skin(44.3%), problems with bowel elimination(35.7%), assistance with bathing(35.7%), pain(30.0%), difficulty in walking(30.0%) , difficulty in seeing(30.0%) problems in urinary elimination(20.0%) , and difficulty in hearing(10.0%), 4. Nursing needs and epidemiological characteristics ; Age distribution was related to the rendition of the mouth but no significant differences were observed statistically with the patients responses to the other nursing history questions according to the epidemiological variables of age, sex, education and residence.

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Synergistic Effect of Forest Environment and Therapeutic Program for the Treatment of Depression (산림활동이 우울증 환자들의 호전에 미치는 영향: 산림치유 프로그램 집단과 병원 프로그램 집단, 산림욕 집단, 대조군 비교 연구)

  • Woo, Jong-Min;Park, Sang Mi;Lim, Seong Kyeon;Kim, Won
    • Journal of Korean Society of Forest Science
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    • v.101 no.4
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    • pp.677-685
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    • 2012
  • This study was conducted to evaluate the effect of forest environment and therapeutic program to the patients with major depressive disorder in antidepressant medication. The first group participated the four sessions of therapeutic program in the forest environment ("forest therapy"), the second group did in the program in a hospital environment, the third group did merely walking in the forest ("forest bath"), and the last group was controls. All the participants was diagnosed with major depressive disorder and had been taking antidepressant medication longer than 3 months. Depressive symptoms were measured by the Hamilton Rating Scales for Depression(HRSD), Montgomery-Asberg Depressin Rating Scales(MADRS), Beck Depression Inventory(BDI), and general health perception was measured by Short Form Health Survey Questionnaire(SF-36). Heart rate variability(HRV) were also examined to observe the physiological parameters before and after the program. In the results, HRSD score of forest program group was significantly lower than controls after the program. MADRS score of forest therapy group and hospital program group was also significantly lower than controls after 4 sessions of the program. The remission rate defined as below 7 points in HRSD was higher in the forest therapy group, hospital program group, forest bath group, and controls in order. These results reveals that the therapeutic program performed in forest environment may improve unremitted depressive symptoms of patients with major depressive disorder. Although not significant, the forest therapy program showed better outcome than hosptial program and forest bath.

Factors Influencing Fear of Falling in Patients with Parkinson's Disease in the Community (지역사회에 거주하는 파킨슨병환자의 낙상공포 영향 요인)

  • Seon, Sun Hee;Kim, Jeong Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.676-687
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    • 2016
  • The purpose of this study was to examine the relation of motor function, depression, and fear of falling, and to identify factors influencing fear of falling in patients with Parkinson's disease in the community. The participants were 180 patients with Parkinson's disease who were selected by convenience sampling. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple linear regression. There was a significant difference in fear of falling according to gender, occupation, walking assistance device, number of falls, Parkinson's disease stage, duration of illness, antihypertensive drug, motor function, and depression. Fear of falling showed significant positive correlations with motor function, and depression. Depression, number of falls, Parkinson's disease stage, gender, antihypertensive drug, and motor function were significant predictors influencing fear of falling in patients with Parkinson's disease, and these variables accounted for 36.0% of the variance. Depression of the influencing factors was the strongest factor. The results of this study suggest that a variety of intervention strategies for preventing or mitigating depression with systematic nursing assessment of the influencing factors on fear of falling are needed to prevent fear of falling in patients with Parkinson's disease.

An Analysis of Fall Incidence Rate and Its Related Factors of Fall in Inpatients (입원환자 낙상 발생 실태와 원인에 관한 분석 연구)

  • Kim, Chul-Gyu;Suh, Moon-Ja
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.210-228
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    • 2002
  • Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

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A Study on the Current Situation and Improved Method for the Smombie through Field Survey and ICT Trend Analysis (현장 조사와 ICT 동향 분석을 통한 스몸비 현황과 개선 방안 연구)

  • Lee, Dong Hoon;Oh, Hye Soo;Jang, Jae Min;Jeong, Jong Woon;Yang, Sang Oon
    • Journal of the Korean Society of Safety
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    • v.35 no.5
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    • pp.74-85
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    • 2020
  • Smart phone zombie or Smombie means pedestrians who walk without attention to their surroundings because they are focused upon their smart phone. Because the traffic accidents and injuries caused by Smombie have been increased rapidly in recent years, the social attention and policies are needed to prevent it. This study was conducted to analyze Smombie's current status and some solutions used before and to propose new improved method through the latest ICT trend. In this study, we did the field survey to check Smombies at several places in Seoul through people counting, and found that a lot of pedestrians still use the smart phone while walking. And we analyzed many case studies about some solutions to prevent Smombies previously. The case studies include legal regulations, government policies, smart phone app services and facilities that are used before. We studied them through internet searches and reference studies and we also checked the current operating situation as visiting several places that the solutions actually has been operated. Therefore, we found there are some limitations in previous solutions in terms of effectiveness and management. To consider new solution that can be expected to overcome the limitations, we analyzed the latest ICT trends focused on features to utilize the Smombie prevention, especially video recognition and digital signage. In these days, video recognition has been developed rapidly with assistance of AI technology and it can recognize the specific pedestrian's characteristics such as holding smart phone as well as hair style, clothes, backpack and etc. On the other hands, the digital signage is the convergence device that includes big display, network connection and various IoT sensors. It can be used as public media in many places for public services as well as advertising. Through these analysis results, we show the requirements and the user scenario for the improved method to prevent Smombie. Finally, we propose to develop R&D technology to recognize Smombie exactly as pedestrian attributes and to spread creative contents to increase pedestrian's interest and engagement for Smombie prevention through digital signage.

A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA) (뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구)

  • Cho Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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