This paper explores into the potential contribution of welfare science and technology(WST) to meeting the challenges of ageing. Drawing on the literature about gerontechnology, this paper considers the application of scientific knowledge for welfare of an aging population. WST for the improvement of the daily functioning of the elderly people can not only prevent, delay or compensate for the declines or impairments of coginitive and physical functions (by assistive technology) but also enhance personal ability to overcome problems either by supporting the person's abilities (by supportive technology) or by changing the environment (by public welfare technology). This paper draws attention to a paradigm change in the conceptualization of disability and its ramifications for the role of technology and aging. A range of approaches such as Barrier-Free design, Universal Design points to new directions of WST in which products and services are devised to improve the quality of life for all people, and hence enhancing the socio-economic vitality. It is suggested that the future of welfare science and technology will be based in large measure on its goal to reduce or prevent individual and structural lag in the relationships between people and their environments. Addressing issues of the broader physical and social environment will emphasize the goal of prevention and the view that environmental needs for aging population are changing over time.
The purpose of this study was to identify frailty profiles based on physical, psychological, and social domains of functioning and to examine the associated factors showing the differences among frailty profiles. Respondents were 70 years and older(n=403) and latent class analysis was applied to determine the optimal subgroups based on Tilberg Frailty Indicators which comprised of three domains(the physical, psychological, and social domain). Also, we performed multinominal logistic regression analysis to find out factors making differences among frailty profiles. Latent class analysis(LCA) identified three distinct types: multi-frail type(27.0%), psychologically frail type(26.8%), inadequate support type(46.2%). All three types had common difficulties in dealing with daily life problems and did not receive enough help with theses difficulties. Based on the results of the LCA three-class models, people in multi-frail type accumulated problems in physical and psychological domains and had partially social domain. On the other hands, psychologically frail type showed a relatively high anxiety disorder and depression. Lastly, people in inadequate support type reported the lack of helps, but they were relatively healthy. Comparing these groups with inadequate support type, people with multi-frail had lower educational level, poor nutritional management status and were less likely to participate in labor market. People in psychologically frail type were more likely to be male, to live in big cities rather than middle and small cities, and less likely to smoke. Based on these results, our results showed the multifaceted concept of frailty among Korean elderly people and we suggested several implications for preventing frail process.
Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.
Purpose: This study provides a treatment for central nervous system development in patients with chronic stroke by investigating changes in the upper limb function over time. The correlations among the activities, participation, and environmental factors of the international classification of functioning (ICF), disability and health are also examined. Methods: The subjects of this study are 18 patients with chronic stroke who were hospitalized and treated at 00 hospital in the Chungcheongbuk-do province. Their upper extremity functions are evaluated using the manual function test (MFT). The activities, participation, and environmental factors are evaluated using the ICF generic form. The correlations between the total scores of the affected and unaffected sides and the ICF items are analyzed using the Pearson correlation analysis. The significance level is p<0.05. Results: When the correlations between the activities and participation areas of ICF and the total score of the affected side of MFT were examined, significant correlations (p<0.05) were found in the following items: changing basic body position (D410), lifting and carrying objects (D430), moving around using equipment (D465), using transportation (D470), washing oneself (D510), caring for body parts (D520), and dressing (D540). When the correlations between the activities and participation areas of ICF and the total score of the unaffected side of MFT were examined, significant correlations (p<0.05) were found among writing (D170), speaking (D330), eating (D550), and drinking (D560). In addition, when the correlation between the environment area of ICF and the total score of the unaffected side of the MFT were examined, significant correlations (p<0.05) were found between products and technology for personal use in daily living (E115) and immediate family (E310). Conclusion: The MFT of patients with chronic stroke is closely correlated with the activities, participation, and environmental factors of ICF. This result suggests that ICF can be used as a useful tool to comprehensively evaluate the abilities of the patient, including the upper extremity function.
Elderly people want to live in the community even if they are in poor health. However, there is no integrated care support system suitable for the health and functional status of the elderly. So the elderly are choosing living facilities. The purpose of this study is to explore exploring whether the elderly are applying for a long-term care certification. First, mild geriatric patients were mainly using home care services such as visitation care. However, some of the milder elderly were enrolled in nursing homes. And the service that does not fit the functional status of the elderly is used. Second, it is concentrated on the use of visiting care services. Third, elderly people outside the class did not receive sufficient help for daily life, and the use of community welfare services such as the elderly welfare center was low. As a result, long-term care admitters are not able to continue to live in the community even though their health and functioning status is mild, and elderly people out of grade are unable to properly use the necessary community care services. The condition is likely to deteriorate.
Depression is a psychiatric disorder characterized by depressed mood, anhedonia, fatigue, and altered cognitive function, leading to a decline in daily functioning. In addition, depression is a serious and common mental illness not only in an individual's life but also in society, so it must be actively treated. Autophagy is involved in the pathophysiological mechanism of mental illness. According to a recent study, it is known that autophagy-induced apoptosis affects neuroplasticity and causes depression and that antidepressants regulate autophagy. Autophagy is a catabolic process that degradation and removes unnecessary organelles or proteins through a lysosome. And, it is essential for maintaining cellular homeostasis. Autophagy is activated in stress conditions, and depression is a stress-related disease. Stress causes damage to cellular homeostasis. Recently, although the role of autophagy mechanisms in neurons has been investigated, the autophagy of depression has not been fully studied. This review highlights the new evidence for the involvement of autophagy in the pathophysiological mechanisms and treatment of depression. To highlight the evidence, we present results from clinical and preclinical studies showing that autophagy is associated with depression. Understanding the relevance of autophagy to depression and the limitations of research suggest that autophagy regulation may provide a new direction for antidepressant development.
Purpose: This study was conducted to investigate newly admitted nursing home resident's experience and adjustment problems in the early stage of institutionalization. Method: In depth interviews was done on 6 elderly residents who were newly admitted. Data from the interview were analyzed using theme analysis method. Results: Results showed that reasons for Institution admission were decreasing physical health and cognitive functioning. Residents reported that difficulties they experienced in institution life were lack of individualized care, loss of autonomy and privacy associated with the demands of group living, and loss of control over activities of daily living. Conclusion: Efforts need to be made to maintain the residents' decision-making and autonomy. Listening intentionally, offering choices, and promoting personal identity might be utilized to reduce relocation stress and enhance adaptation to nursing home living.
Kim, Min-Jee;Kim, Young-wook;Kim, Jun-hyeok;Kim, Ga-hee;Choi, Hong-seok;Moon, Kwangtae
Therapeutic Science for Rehabilitation
/
v.12
no.4
/
pp.53-65
/
2023
Objective : This study aimed to identify the experiences and practices of occupational therapists in mental health and provide interventions for improving body function in individuals with mental illness. Methods : Data were collected from mental health therapists between November 7 and November 14, 2022. A survey was distributed via email and 46 responses were analyzed using descriptive statistics and correlations. Results : The majority were female (58.7%), aged 20-30 years (84.8%), working in mental health centers (41.3%), and undergoing mental health occupational therapy training (91.3%). They had 1-3 years of mental health experience (65.2%) and were commonly involved in programs (71.1%), case management (62.2%), and administration (57.8%). Interventions for physical functioning were common (73.9%), including group interventions (41.2%), such as stretching, aerobic exercise, and walk training, and individual interventions (38.1%), such as walking, stretching, and aerobic exercise. Conclusion : Occupational therapists play a crucial role in enabling individuals with mental illness to engage in daily life activities. However, relevant studies in this field are lacking. This study emphasizes the importance of mental health occupational therapy and the need for evidence-based services for physical function improvement interventions to provide more effective treatments for mental illnesses.
In order to investigate the factors influencing QOL and life satisfaction of the physically disabled, the author interviewed, by using structuralized questionnaire, 440 individuals among the physically disabled who were participated in Health Examination from April to July, 1997. The questionnaire consisted of the general characteristics(sex, age, marital status, family number, etc), the Reintegration to Normal Living Index(RNLI) to assess QOL, and the single item of five-likert scale to evaluate life satifaction. The means of RNLI were $16.2{\pm}4.8$ in total score, $12.2{\pm}3.4$ in daily functioning and $4.0{\pm}2.1$ in perception of self. The respondents were less reintegrated toward social activities and relationships than impairments or disabilities. While the satisfied group was 47.3%, the dissatisfied group was 52.7%. As the results of multiple regression and logistic regression analysis, the significant predictors of QOL were age, education, job, grade of disability and subjective health status. The life satisfaction were related to economic status, job and subjective health status. To improve QOL and life satisfaction of the physically disabled, it is important that we improve their basic socioeconomic status by getting a job through rehabilitation education and induce them to have positive self-assessment by extending the opportunity of social participation.
Objectives : To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. Methods : A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. Results : The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability(78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. Conclusions : PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.
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