• Title/Summary/Keyword: chronic disease/disability

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Factors Associated with Physical Functioning among Community-Dwelling Older Adults (우리 나라 재가노인의 신체적 기능상태별 관련 요인)

  • Choi, Kwi-Sook;Lee, Yun-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.325-332
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    • 1999
  • Objectives: The aim of this study is to identify major factors associated with physical functioning among the Korean elderly. Methods: Data come from a survey of a nationally representative sample of 2,058 older people aged 60 years or elder living in the community. A hierarchical functioning scale was constructed, using upper and lower body mobility, IADLs, and ADLs. Socioeconomic characteristics, chronic conditions, measures of health status, health service use, and social support were analyzed to explore their influence on functioning. Polytomous logistic regression analysis was conducted to identify major contributing factors to different levels of functioning. Results: Persons of older age, female, with chronic diseases (heart disease, stroke, fracture/dislocation) were consistently more likely to show a higher degree of functional limitation. There were variations, however, among other factors; e.g., those with arthritis were more likely to be only mildly impaired, but not moderately or severely impaired. Conclusions: Older Korean adults living in the community with impaired functioning constitute persons with diverse characteristics. Policy and program activities need to address specific needs of older people in different functioning states.

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Health Conditions Sensitive to Retirement and Job Loss Among Korean Middle-aged and Older Adults

  • Park, Su-San;Cho, Sung-Il;Jang, Soong-Nang
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.3
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    • pp.188-195
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    • 2012
  • Objectives: This study was conducted to examine the association between health condition and leaving the labor market among middle-aged and older adults in South Korea. Methods: Data was obtained from individuals aged 45 years and older participating in the 2006 and 2008 Korean Longitudinal Study of Ageing. We used various health measures including chronic diseases, comorbidities, traffic accident injuries, disabilit of instrumental activities of daily living, depressive symptoms, and self-rated health. The odds ratios of job loss, and retirement, versus employment were calculated using multinomial logistic regression by each health measure. Results: In our cross-sectional and longitudinal analysis, health problems related to physical disabilities had the greatest effect on leaving the worksite. A shift in health condition from good to poor in a short period was a predictor of increased risk of unemployment but a persistent pattern of health problems was not associated with unemployment. Women with health problems showed a high probability of retirement, whereas among men, health problems instantly the possibility of both job loss and retirement. Conclusions: Health problems of middle aged and older workers were crucial risk factors for retirement and involuntarily job loss. Especially functional defect and recent health problems strongly and instanty affected employment status.

Traditional Korean Medicine Usage and Perception: a comparative study between the general population and the disabilities

  • Han, Ji-Eun;Kim, Jihye;Kim, Kyeong Han;Lee, Ji-Yeon;Sung, Soo-Hyun
    • Journal of Pharmacopuncture
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    • v.25 no.1
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    • pp.24-36
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    • 2022
  • Objectives: This study is a comparative analysis of the satisfaction and recognition characteristics for traditional Korean medicine (TKM) in people with disabilities and the general population of Korea. Methods: Here, 5,000 subjects were categorized into two groups based on a disability rating using the data from the 2017 National Survey for the Usage of Korean Medicine. The relationships among the sociodemographic characteristics, TKM usage status, recognition of TKM usage, and recognition of the effectiveness of the TKM treatment were analyzed based on the disease. The response reliability was verified using the chi-square test analysis method. Results: Disabilities corresponded with low rates of high school or higher education (44%, 83.5%) and no jobs (56.9%, 33.5%), mostly the status of the low-income class with a monthly household income of < 1,500 USD (50.9%, 10.5%), poor health conditions (55.2%, 9.8%), high chronic disease prevalence rate (69.0%, 19.9%), high medical care rate (11.2%, 0.5%), and low commercial health insurance subscription rate (44%, 74.2%). Furthermore, people with disabilities visited TKM institutions more often (88.8%, 74.1%) with a high frequency TKM usage rate of ≥ 1-2 times a month (26.2%, 15.3%). They also reported that the cost of using the TKM was very high (14.7%, 8.8%) and that primarily the application of insurance benefits should be improved (52.6%, 47.5%). The treatment effectiveness for diseases was high for musculoskeletal disorders for both people with disabilities and the general population. Conclusion: Preferential application of insurance benefits for musculoskeletal diseases must be extended to the TKM treatment as well, as people with disabilities have a high recognition for these conditions with TKM. It is difficult to perform randomized controlled trials on people with disability. Therefore, large-scale observational and cohort studies should be conducted. We hope this study will help establish a suitable TKM policy for people with disabilities.

Mediating Effect of Self-esteem on the Relationship between Economic, Health Characteristics and Life Satisfaction of Elderly People with Disability (고령장애인의 경제적 및 건강 특성과 삶의 만족도 관계에 대한 자아존중감의 매개효과)

  • Jeong, Moon-Jhin;Lee, Seong-Gyu
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.551-560
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    • 2017
  • This study is aimed at finding plans to enhance life satisfaction of elderly people with disability. For this, it analyzed the influence of economic characteristics and health characteristics upon life satisfaction, as well as a mediating effect of self-esteem. This study utilized data from the $7^th$ Panel Survey of Employment for the Disabled(PSED). The results are as follows, First, life satisfaction was high in the case of being employed and when old-age preparation was ready, current status of health, whether or not they need help in their daily life, chronic disease. Second, the mediate effect of self-esteem was analyzed for the influence of the plan for old age, good health condition and other's help in daily life upon life satisfaction. That is, those enhanced the self-esteem and it played an important role to improve life satisfaction. Based on such study results, this study recommends a number of the policy suggestions.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA: CASE REPORT (모야모야병(moyamoya disease) 환자의 전신마취 하 치과치료: 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.40-44
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    • 2019
  • Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease of unknown etiology characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. The clinical presentations of MMD include transient ischemic attacks (TIA), ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. MMD is the most important cause of stroke or TIA in children in East Asian countries. A 5-year-3-month old boy with MMD experienced cerebral infarctions five times. Cerebrovascular anastomosis surgery was performed on him four years ago. He had dysphagia, developmental delay, hemiplegia, and strabismus. Besides, a number of dental caries in primary dentition were identified during clinical oral examination. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation and underlying systemic disease. MMD is associated with various medical diseases requiring thoughtful consideration during dental treatment. Crying and hyperventilation in MMD patients may cause hypocapnia and have a cerebral vasoconstrictive effect. If dental treatment is required, control of pain and anxiety is very important. General anesthesia may be considered for dental treatment in uncooperative or very young patients with MMD.

Effect of Sa-am Acupuncture Method for Chronic Tension-type Headache;A Randomized Controlled Trial (만성 긴장성 두통 환자에 대한 사암침 치료효과의 Pilot 임상연구)

  • Hong, Kwon-Eui;Park, Yang-Chun;Jo, Jeong-Hyo;Jo, Hyun-Gyeong;Jeong, In-Cheol;Kang, Wee-Chang;Lee, Sang-Bong;Choi, Sun-Mi
    • Journal of Acupuncture Research
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    • v.24 no.1
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    • pp.13-28
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    • 2007
  • Objectives : Clinical character of chronic tension-type headache is bilateral, moderate intensity, persistent and chronic, repeating disease and CTTH is a common prevalent disease, but pathophysiology and likely mechanism remain unclear. It impedes subjective quality of life. The purpose of this research is to examine the effect of sa-am acupuncture method for chronic tension-type headache. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of chronic tension-type headache was measured by VAS and Headache Disability Inventory(HDI), Six point Linkert Scale before and after treatments. Results : 26 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, Byeonjeung, sunrise of treatment. In change of VAS, there were not difference between two groups on before treatment. Before treatment per visit, VAS of 6th and 7th visit were significantly decreased in active acupuncture(each p=0.039, p=0.008) and were not decreased in sham acupuncture. In change of VAS on a withdrawing needling after treatment, VAS of 1st, 2nd, 6th and 7th visit were significantly decreased in active acupuncture (each p=0.001, 0.038, 0.035, 0.008) and VAS of 2nd, 4th and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.033, 0.032, 0.035, 0.031). In change of VAS on 2hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.014, 0.023, 0.027) and 5th visit were significantly decreased in sham acupuncture(each p=0.004, 0.009). In change of VAS on 4hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.018, 0.011, 0.015) and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.020, 0.015). In change of VAS on the next day after treatment, VAS of 3th and 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.032, 0.011, 0.005, 0.012) and 4th, 5th visit were significantly decreased in sham acupuncture(each p=0.001, 0.012). In change of VAS according to a current time(before treatment, after a withdrawing needling, 2hrs, 4hrs, the next day), total score of VAS was decreased more active acupuncture group than sham acupuncture group, but there were no statistical significance compared with sham acupuncture group. In change of HDI score, after treatment was decreased than before treatment in two group, but there were no statistical significance compared with two group. In change of Six point Linkert scale score, after treatment was decreased than before treatment in two group on 6th, 7th visit(active acupuncture 6th 7th each p=0.002, 0.003, sham acupuncture 6th 7th each 0.003, 0.009), but there were no statistical significance compared with tow group. Conclusion : Sa-am acupuncture treatment is effective to improve the symptoms and quality of life in patients with chronic tension-type headache.

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An Empirical Study on Factor Associated with Mood Disorders in Elderly: Focusing on the Influence of Community Characteristics (노인 기분장애 영향요인에 관한 실증적 연구: 지역사회 특성의 영향을 중심으로)

  • Chang, Miseung;Shim, Ik Sup
    • Health Policy and Management
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    • v.27 no.2
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    • pp.177-185
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    • 2017
  • Background: The mental problems of the elderly are at issue as a serious social phenomenon. The purpose of this study is to identify risk factors affecting the mood disorders of the elderly. Methods: The subjects were 1,779,236 aged ${\geq}65$ and participated in health screening. Dependent variable was mood disorders. Independent variables were consisted of community level (regional deprivation index and healthcare resources) and individual level (sex, age, insurance type, disability, smoking, alcohol, physical activity, body mass index, and healthcare utilization). Multilevel logistic regression was performed. Results: At the individual level, women, employed insured, severely disabled people, heavy alcohol drinkers, high-intensity physical activity, body mass index, and patients who had chronic disease and severe disease were significantly associated with mood disorders. As the age has increased, it has let increase of mood disorders. At the community level, as the regional deprivation index has increased by 1, mood disorders has been increased by 1.005 times. The intra-class coefficient was 7.04%. Conclusion: We found individual and community level factors are associated with mood disorders. Systematic approach is essential to reduce mood disorders.

Juvenile idiopathic arthritis: Diagnosis and differential diagnosis

  • Kim, Ki-Hwan;Kim, Dong-Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.931-935
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    • 2010
  • Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of several disease subtypes that are characterized by the onset of arthritis before the age of 16 years and has symptoms lasting at least 6 weeks. The previous classification of JIA included seven different categories, whereas its current classification was compiled by the International League of the Association for Rheumatology, and replaced the previous terms of "juvenile chronic arthritis" and "juvenile rheumatoid arthritis," which were used in Europe or North America, respectively, with the single nomenclature of JIA. As mentioned above, JIA is defined as arthritis of unknown etiology that manifests itself before the age of 16 years and persists for at least 6 weeks, while excluding other known conditions. The clinical symptoms of JIA can be quite variable. Several symptoms that are characteristic of arthritis are not necessarily diagnostic of JIA and may have multiple etiologies that can be differentiated with careful examination of patient history. The disease may develop over days or sometimes weeks, thereby making the diagnosis difficult at the time of presentation. To make a clinical diagnosis of JIA, the first step is to exclude arthritis with known etiologies. Of note, late treatment due to excessive delay of diagnosis can cause severe damage to joints and other organs and impair skeletal maturation. Therefore, early detection of JIA is critical to ensure prompt treatment and to prevent long-term complications including the likelihood of disability in childhood.

A Study of Low Back Pain Patient's Satisfaction with Physical Therapist in Seoul and Uijongbu City (요통환자의 물리치료사 만족도에 대한 조사 -서울 및 의정부 시 일부 병, 의원에 내원하는 외래, 재진 환자를 중심으로-)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.37-50
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    • 1997
  • Low back Pain(LBP) is a common problem, and the resulting disability frequently contains nonorganic, psycho-logical and social elements that are difficult for the physical therapists to manage. The physical therapist-patient relationship is the most important factors in the management of low back pain as chronic disease. The purpose of this study was to evaluate and to identify factors that had influenced low, back pain patients satisfaction with physical therapist The subjects of this study were 223 out-patients(116 males and 107 females) who had been visited to physical therapy room of medical institutions in Seoul and Uijgngbu city. They were examined by the questionaire of Dimatteo and Hays which was amended to serve the purpose of this study by author. The collected data was analyzed by ANOVA according to the purpose of this study. There was no difference with statistic value in LBP patient's satisfaction according to occupation, sex, schooling, religion, marital status, medical security, duration of disease, the tine required, recurrence, but was a difference according to age, income, period of treatment, cost, diagnosis, waiting time, the number of physical therpy's sort, sex ane age of physical therapists (p<.05). LBP patients was satisfied with physical therapist's communicative behavior, but was dissatisfied with physical therapist's competence.

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Risk Factors Associated with Frequent Hospital Readmissions for Exacerbation of COPD

  • Kim, Mi-Hyun;Lee, Kwang-Ha;Kim, Ki-Uk;Park, Hye-Kyung;Jeon, Doo-Soo;Kim, Yun-Seong;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.4
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    • pp.243-249
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    • 2010
  • Background: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality worldwide. The aim of this study was to evaluate the risk factors associated with recurrent hospital admissions for exacerbation of COPD in Korea. Methods: A retrospective study of 77 consecutive patients hospitalized for exacerbation of COPD at Pusan National University Hospital during the time period January 2005 to May 2008 was performed. The information was collected from the hospitalization period: clinical information, spirometric measures, and laboratory variables. In addition, socioeconomic characteristics, co-morbidity, anxiety, and depression were reviewed. Frequent readmission was defined as 2 or more hospitalizations in the year following discharge. Results: During the 1-year period after discharge, 42 patients (54.6%) reported one hospital admission and 35 patients (45.4%) reported 2 or more hospital readmissions. Among the 35 frequent readmission patients, 4 had more than 10 readmissions. Univariate analysis showed that a body mass index (BMI) <$18.5kg/m^2$, duration >36 months, forced expiratory volume in 1 second ($FEV_1$) <50% predicted, arterial $CO_2$ partial pressure ($PaCO_2$) >40 mm Hg, and arterial oxygen saturation ($SaO_2$) <95% at discharge were associated significantly with frequent readmissions. The multivariate analysis revealed that BMI <$18.5kg/m^2$, $PaCO_2$ >40 mm Hg at discharge were independently associated with frequent readmissions for exacerbation of COPD. Conclusion: Frequent readmissions for exacerbation of COPD were associated with low BMI and hypercapnia at discharge.