• Title/Summary/Keyword: geriatric assessment

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The Development of Physical Functioning Scale for Community-Dwelling Older Persons (지역사회 노인의 신체기능 평가도구 개발)

  • Lee, Kyung-Jong;Han, Geun-Shik;Yoon, Soo-Jin;Lee, Yeon-Kyung;Kim, Chan-Ho;Kim, Jeong-Lim;Lee, Yun-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.359-374
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    • 2002
  • Objectives : To develop a physical functioning instrument for older adults living in the community. Methods : A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. Results : Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PT) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, surrey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. Conclusions : The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.

Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg's Syndrome: A Case Study (발렌버그 증후군(Wallenberg's Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.69-83
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    • 2022
  • Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

Association Between Cognitive Impairment and Oral Health Related Quality of Life: Using Propensity Score Approaches (인지기능과 구강건강관련 삶의 질의 연관성에 대한 연구: 성향점수 분석과 회귀모델을 중심으로)

  • Cha, Suna;Bae, Suyeong;Nam, Sanghun;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.61-77
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    • 2023
  • Objective : This study analyzed the correlation between cognitive function and oral health-related quality of life (OHQoL). Methods : Demographic and clinical characteristics were extracted and utilized for subjects aged 45 years or older who participated in the 8th Korean Longitudinal Study on Aging in 2020. The dependent variable was the Geriatric Oral Health Assessment Index, and the independent variable was the level of cognitive function classified by the Mini-Mental State Examination scores. The analysis method used inverse probability of treatment weighting (IPTW). Then, the association between cognitive function and OHQoL was analyzed by multiple regression analysis. Results : Among the participants, 4,367 (71.40%) had normal cognition, 1,155 (18.89%) had moderate cognitive impairment, and 594 (9.71%) had severe cognitive impairment. As a result of analysis by applying IPTW, there was a negative correlation between the cognitive function group and OHQoL (normal vs. moderate: β = -2.534, p < .0001; normal vs. severe: β = -2.452, p < .0001). Conclusion : After propensity score matching, mild cognitive impairment showed a more negative association than severe cognitive impairment. Therefore, patients with cognitive impairment require oral health management education to improve OHQoL regardless of the level of cognitive impairment.

Factors Associated with Successful Aging of Korean Older People Living in a City (일 도시 노인의 성공적인 노화 관련 요인)

  • Shin, Younghee;Lee, Hyejung
    • 한국노년학
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    • v.29 no.4
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    • pp.1327-1340
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    • 2009
  • The purposes of the study were (1) to identify the level of successful aging of older people living in a city, (2) to identify associated factors with successful aging, and (3) to identify a risk group for successful aging using classification and regression trees (CART) analysis. One hundred eighty seven older people (>65years) participated in the cross-sectional survey. Trained interviewers collected data with a structured questionnaire on demographic information, Korean geriatric depression score, activity of daily living(ADL), instrumental activity of daily living(IADL), and Young's successful aging instrument in subject's home. A CART analysis split subjects into ten homogeneous small groups based on five determinant factors. Older people who are male, with higher education, living with family, and not receiving Medicaid showed better scores in successful aging than their counter parts. Depression was a strong primary determinant for successful aging. A risk group for successful aging of older people was identified by depression and IADL. An intervention to prevent and manage depression and to improve physical function of older people can be developed to promote successful aging of older people. It is suggested to consider an assessment of depression to develop the policies for older people welfare.

The Effects of 8-weeks Jeol Meditation Program on Stress, Depression and Cardiovascular Risk Factors in Women (8주간의 절명상 프로그램이 여성의 스트레스, 우울 및 심혈관 위험인자에 미치는 효과)

  • Jung, HwanSug;Kang, YuneSik
    • Journal of agricultural medicine and community health
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    • v.38 no.3
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    • pp.163-173
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    • 2013
  • Objectives: There has been an increase in the use of mind-body therapies to control cardiovascular risk factors recently. This trial was designed to determine whether the 'jeol'(Korean Buddhists' prostration) meditation program, as a new mind-body intervention, was effective in managing stress, depression and controlling cardiovascular risk factors in women working at a geriatric hospital. Methods: We conducted a randomized controlled trial to determine whether the 'jeol' meditation program could improve stress, anxiety, depression, and cardiovascular risk factors in women. We randomly assigned 57 participants to the intervention(29 participants) or control(28 participants) group. The subjects in the intervention group participated in a group Jeol meditation program once weekly, and practiced at home. The following variables were assessed: stress(Psychosocial Wellbeing Index), depression(Beck's Depression Inventory), body mass index(BMI), waist circumference, hemoglobin A1c(HbA1c), homeostasis model assessment(HOMA), low-density lipoprotein(LDL) cholesterol, high-density lipoprotein(HDL) cholesterol, and triglyceride were assessed. Results: After the 8-week program, 2 participants from the intervention group and 1 from the control group dropped out. The subjects in the intervention group exhibited decreased scores for stress(t=5.102, p<0.01), depression(t=5.259, p<0.01), BMI(t=2.942, p=0.007), and waist circumference(t=2.582, p=0.016); however these scores did not demonstrate a significant decrease in participants of the control group. The other variables showed no significant difference between the groups. Conclusion: The 'jeol' meditation program evidently reduced stress, anxiety, depression, body weight, and waist circumference in women, which suggests that this program could be employed as a mind-body therapies.

The Effects of Trunk Stabilization Training on a Stroke Patient's Postural Control and Activities of Daily Living: A Sing Subject Design (뇌졸중 환자의 체간안정화 훈련이 자세조절과 일상생활동작에 미치는 영향: 단일사례연구)

  • Nam, Ju-Hyeon;Shim, Gyeong-Bo;Gwak, Seong-Won
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.1
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    • pp.75-84
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    • 2014
  • Objective : This study intends to suggest an effective clinical intervention method for stroke patients by applying a trunk stabilization training program to a single stroke patient and investigating and analyzing the effects of the program on postural control and activities of daily living. Methods : The subject of this study was a 75 year-old female stroke patient hospitalized in C Hospital located in Gyeongju, Gyeongsangbuk-do. As for the research design, A-B-A reversal design was used with a single subject design; and the research period was a total of five weeks from April 21, 2014 to May 23, 2014. As for the research process, a total of 15 sessions were carried out including three sessions of baseline(A), nine sessions of an intervention period(B), and three sessions of maintenance(A'); and the trunk stabilization program was applied during the intervention period. To evaluate the participant's postural control and activities of living life, the Postural Assessment Scale for Stroke(PASS) and the modified Barthel Index(MBI) were used. Visual analysis was used in which collected data were plotted on a graph, using Microsoft Office Excel 2013. Results : In the postural control test, the mean scores improved from 11.7 in the baseline phase to 14.8 in the intervention phase and 15.3 in the maintenance phase. In the evaluation of activities of daily living, the score improved from 66(medium dependence) during the baseline period to 80(low dependence) after intervention and at the maintenance phase. Conclusion : It was found that the trunk stabilization training program showed effects on the stroke patient's postural control or alignment, and furthermore a beneficial improvement in the patient's performing the activities of daily living, as well.

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A Study on Correlations Among Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관 질환 환자에서 인지기능, 정신행동 증상 및 일상 생활 기능간의 상관에 대한 연구)

  • Lee, Young-Ho;Park, Young-Soo;Choi, Hong;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Suk-Hai;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.170-181
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    • 1996
  • Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

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A Survey of Role Perception and Function Performance Related to Public Health Service among the Medical Staff in a National Hospital (일개 공공병원 종사자의 공공보건의료에 대한 인식과 기능수행에 대한 조사연구)

  • Cho, Young-Hye;Lee, Sang-Yeoup;Jeong, Dong-Wook;Choi, Eun-Jung;Kim, Yun-Jin;Lee, Jeong-Gyu;Go, Yu-Young;Lee, Yu-Hyone;Bae, Mi-Jin;Kim, Chang-Hoon
    • Journal of agricultural medicine and community health
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    • v.37 no.2
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    • pp.67-75
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    • 2012
  • Objectives: While there have recently been efforts to improve public health service at a governmental level, there is actually insufficient research on awareness of the roles related to public health service among hospital employees. This study examined role perception and function performance related to public health service among the medical staff in a national hospital. Methods: 15% were randomly sampled from each type of occupation among the medical staff in a national university hospital, a survey was conducted in 323 persons, and there were a total of 265 participants (80.2%): 103 doctors(38.9%), 98 nurses (37.0%), and 64 others (24.1%). Results: The hospital employees had insufficient awareness of their roles as public health service providers in terms of six required items for public health service: 1) services for supporting establishment, implementation, and assessment of public health service policies, 2) participation in the health service activities and support services by central or local governments, 3) technological support and educational services for private health service institutions, 4) health service for unprivileged brackets, 5) health service that requires association with other areas dealing with geriatric, disabled, and mentally-disordered people, and 6) health service for children and mothers. Conclusions: In general, since the hospital employees had insufficient awareness of their roles and responsibilities as public health service providers, it is necessary to secure manpower exclusively in charge of public health service and provide education about strategic public health service.

A Study on the Differences of Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions According to the Lateralization of Lesion in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 병소의 편측성에 따른 인지기능, 정신행동증상 및 일상생활기능의 차이에 대한 연구)

  • Park, Young-Soo;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Suk-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.56-67
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    • 1996
  • Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

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