• Child Health Nursing Research
• /
• 제6권2호
• /
• pp.199-211
• /
• 2000

Today, more chronically ill and handicapped children are being cared for at home by a family member caregiver. The task of caring for a family member may feel burden that the caregiver has less time and money and more work. Family functioning and their burden have influence on coping and adaptation of families with chronically-ill children. This study attempted to identify the levels of burden and family functioning in families of children with cerebral palsy and to examine their relationships. The instruments were burden scale developed by Suh and Oh(1993), and a modified Feetham Family Functioning Survey based on Roberts and Feetham.(1982). The subjects were 98 parents of children, under 15 years, who have cerebral palsy and being treated and living in Pusan. Data were collected through a self-administered question- aire from April 26 to May 29. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows ; 1. The mean rating scores of burden and family functioning were 2.79±.51 and 4.12±.69, respectively. 2. The relationships between general character- istics and burden were statistically significant difference : degree of children's handicap(F=6.333, P<.01). The relationships between general characteristics and family functioning were statistically significant differences : familial relation with the children(F=3.628, P<.05), caregiver's health status(F=4.359, P<.05), age of children (F=4.185, P<.05), and duration of treatment (F=6.802, P<.01). 3. In families of children with cerebral palsy, there was significantly negative correlation between the burden of parents and the performance of family functioning(r=-.230, P<.05). There were significantly negative correlations between the burden of parents and the satisfaction of family functioning (r=-.211, P<.05), and between the perceived importance and the satisfaction of family functioning(r=-.481, P<.01); however, there was a positive correlation between the performance and the perceived importance of family functioning(r=.425, P<.01). In conclusion, this study suggests that families of children with cerebral palsy need family-focused nursing interventions as supportive care for relieving their burden and for improving family functioning.

• 대한소아치과학회지
• /
• 제35권1호
• /
• pp.102-109
• /
• 2008

2004년 보건복지부에서 시행한 전국 장애인 구강보건실태조사 자료 중 만 6-17세 사이의 소아 청소년 장애인 677명을 대상으로 하여 장애유형을 신체장애, 정신지체 및 감각장애로 분류한 후 이들의 치아우식증 실태를 파악하여 다음과 같은 결론을 얻었다. 소아 청소년 장애인들의 전체 평균 우식경험영구치지수와 우식경험영구치면지수는 각각 3.06개 및 5.24면이었고, 각 연령대별 우식경험영구치지수와 우식경험영구치면지수는 6-8세는 0.90개 및 1.45면, 9-11세는 2.32개 및 3.76면, 12-14세는 3.63개 및 6.33면 그리고 15-17세는 4.93개 및 8.35면이었다. 또한 소아.청소년 장애인들의 우식경험영구치지수에 유의한 영향을 미친 변수로는 연령, 잇솔질 횟수 및 잇솔질 의존도 그리고 저작 및 기능장애이었다. 연령이 증가할수록(b=1.34, p<0.001), 잇솔질 횟수가 적을수록(b=-0.27, p=0.034), 잇솔질을 자력으로 하는 경우에(b=-1.43, p<0.001), 그리고 구강 내에 저작 및 기능장애가 있는 경우에(b=1.24, p=0.011) 우식 경험영구치지수가 유의하게 높았다. 또한 우식경험영구치면지수에 유의한 영향을 미친 변수는 연령, 잇솔질 횟수 및 잇솔질 의존도로, 연령이 증가할수록(b=2.49, p<0.001), 잇솔질 횟수가 적을수록(b=-0.66, p=0.024) 그리고 잇솔질을 자력으로 하는 경우(b=-1.75, p=0.042)에 우식경험영구치면지수가 유의하게 높게 나타났다. 따라서 우리나라 소아 청소년 장애인들의 치아우식증의 진행과 중증도를 감소시키기 위해 각 연령대별로 보다 효과적인 잇솔질 교습을 포함한 구강건강증진 프로그램을 개발하여 적용하는 것이 필요한 것으로 사료되었다.

• 대한후두음성언어의학회지
• /
• 제29권1호
• /
• pp.30-36
• /
• 2018

Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

• 대한한방내과학회지
• /
• 제38권3호
• /
• pp.392-400
• /
• 2017

Objective: To report the case of a patient suffering from cervical vertigo who was treated with a combination of Korean medicine treatments (including acupuncture, pharmaco-acupuncture, and Chuna manual therapy). Method: An outpatient with cervical vertigo was given a combination of Korean medicine treatments five times, from December 5 to 16, 2016. All of the treatments, acupuncture with electric stimulation and pharmaco-acupuncture, were applied on the trigger points (TP) of the cervical muscles and the upper trapezoid muscles. Chuna manual therapy was then applied on the cervical area. The Numeric Rating Scale (NRS) - according to outpatient's statement on vertigo, neck pain and headache - and the Korean Dizziness Handicap Inventory (DHI), which is a self-evaluating scale of dizziness in daily life, were used to evaluate the effects of this treatment. Results: At the end of the treatment, the vertigo and the headache disappeared. The NRS decreased from 9 to 0 for vertigo and from 5 to 0 for headache. Although the neck pain also decreased, it did not disappear; this NRS decreased from 7 to 1. The DHI score also decreased significantly, from 64 to 4. Conclusion: Since the symptoms of the patient with cervical vertigo improved after the very first treatment and the improvement of the symptoms was observed as the treatment progressed, this case report is worth supporting the efficacy of combined Korean medical treatments. However, because there was only one subject, it is hard to say that this efficacy can be generalized. Moreover, this report cannot prove the individual efficacy since various treatments were combined. While there are many researches related to cervical vertigo in Western medicine, the studies in Korean medicine are comparably insufficient; therefore, follow-up research on more subjects is needed.

• 한국산학기술학회논문지
• /
• 제17권2호
• /
• pp.601-609
• /
• 2016

본 논문은 관절염을 앓고 있는 노인여성(환자군; $65.25{\pm}5.9$세, 11명)과 일반 노인여성(통제군; $64.50{\pm}7$세, 11명)을 대상으로 12주간의 수중운동(주 3회)을 실시 한 후 동적평형성과 통증(통증자각도)의 변화를 알아보고자 실시되었다. 동적평형성은 시각정보의 유무에 따라 개안 시와 폐안 시로 나누어 측정하였다. 12주간의 수중운동에 따른 개안 시 동적평형성은 관절염 환자군(p<.001)과 통제군(p<.05)에서 유의하게 향상되었고, 폐안 시 관절염 환자군에서도 유의하게 향상된 결과를 보였다(p<.05). 또한, 통증자각도(VAS) 평가에 의한 통증 변화는 관절염 환자군의 10요인(푹신한 의자에 똑바로 앉아있기 힘든가, p<.01), 11요인(누워있을 때 통증이 덜해지는가, p<.05), 12요인(통증때문에 일상생활에 지장이 있는가, p<.05), 13요인(통증 때문에 직장일 또는 집안일에 지장이 있는가, p<.01)에서 유의한 통증 감소가 나타났다. 본 연구 결과를 통해 12주간의 수중 운동은 골관절염 노인 환자에게 개안 시와 폐안 시 모두 동적평형 능력을 향상 시키고, 일부 통증요인 감소에 효과적인 운동임을 알 수 있었다.

• 한국치위생학회지
• /
• 제11권5호
• /
• pp.717-727
• /
• 2011

Objectives : This study was purposed to estimate the level of oral health quality of life and the relationship between health-related factors and oral health quality of life in patients with successful dental implants. Methods : This questionnaire survey was conducted during the period from December 2009 to March 2010 with 126 patients confirmed successful dental implants in Busan. The oral health related quality of life and oral health-related factors were estimated with OHIP-14 and 8 oral health characteristics, respectively. Data analysis was performed with descriptive analysis, t-test, ANOVA, multiple regression analysis using SAS(ver 9.1) program. Results : The score of oral health quality of life in patients with successful dental implants was $12.25{\pm}7.82$. The scores of subscale of the oral health quality of life were $1.24{\pm}1.35$ in social disability, $1.60{\pm}1.37$ in handicap, $1.60{\pm}1.44$ in psychological disability, $1.70{\pm}1.38$ in functional limitation, $1.81{\pm}1.35$ in physical disability, $2.14{\pm}1.46$ in physical pain, $2.17{\pm}1.46$ in psychological discomfort, respectively. The related factors of oral health quality of life in patients with successful dental implants were absence of other type prosthesis and experience of tooth brushing education. Conclusions : The oral health related quality of life in patients with successful dental implants was relatively good condition. Social supports and chances for high quality denture and tooth brushing educations are needed to improve oral health related quality of life in patients with dental implants.

• 기술혁신연구
• /
• 제20권1호
• /
• pp.45-73
• /
• 2012

본 연구는 2000년부터 2010년까지 한국거래소의 유가증권시장과 코스닥시장에 상장된 기업을 대상으로 기업의 재무적 특성변수가 R&D 투자와 기업가치간의 관계에 미치는 영향을 실증분석 하였으며, 주요한 분석결과는 다음과 같다. 기업규모는 R&D 투자와 기업가치간의 관계에 양(+)의 영향을 미친다. 이는 R&D 투자는 중소기업보다 대기업의 기업가치에 더 큰 영향을 미침을 의미한다. 기업의 잉여현금흐름은 R&D 투자와 기업가치간의 관계에 음(-)의 영향을 미친다. 이는 잉여현금흐름이 높은 기업은 순현재가치(NPV)가 음(-)인 투자안에 여유자금을 투자할 과잉투자위험이 존재한다는 Jensen(1986)의 이론을 지지한다. 기업의 시장점유율은 R&D 투자와 기업가치간의 관계에 양(+)의 영향을 미친다. 시장점유율과 R&D 투자는 상호보완적으로 작용하므로, 시장점유율이 높은 기업은 R&D 투자도 증가하여 시장가치가 증가한다. 기업의 외부금융 의존도는 R&D 투자와 기업가치간의 관계에 음(-)의 영향을 미친다. R&D 투자는 비대칭정보로 인한 역선택비용을 크게 발생시키므로, 외부금융에 의존하기보다 내부금융을 사용하는 것이 더 유리할 수 있다. 그리고 기업의 노동집약도와 자본집약도는 각각 R&D 투자와 기업가치간의 관계에 음(-)의 영향을 미치는데, 전자는 노동집약도가 높은 기업일수록 종업원들 간에 초과수익률이 희석될 가능성이 높기 때문이고, 후자는 자본집약도가 높은 기업일수록 재무적 제약에 직면할 가능성이 높기 때문이다. 결론적으로, 본 연구에서 설정한 기업의 재무적 특성변수 중에서, 기업규모와 시장점유율은 R&D 투자와 기업가치간의 관계에 양(+)의 영향을 미치지만, 잉여현금흐름, 외부금융의존도, 노동집약도 및 자본집약도는 음(-)의 영향을 미친다. 따라서 기업 경영자들은 이러한 재무적 특성변수들이 R&D 투자와 기업가치간의 관계에 미치는 영향을 올바르게 이해하여 R&D 투자를 결정함으로써 기업가치를 증가시킬 수 있다.

• 대한후두음성언어의학회지
• /
• 제20권1호
• /
• pp.63-67
• /
• 2009

Background and Objectives: In patients with asthma, increased obstruction and resistance of airway result in impairment in the generation of voice. Allergy and nasal polyposis, which are frequently observed in patients with asthma, are other factors that affect the vocal performance. Bronchodilators and steroids are commonly used in the treatment of asthma, and these agents also have been reported to be associated with voice changes. The aim of this study is to evaluate the voice quality in patients with mild to-moderate asthma by subjective and objective methods. Materials and Methods: A total of 36 patients with asthma established in the Department of Respiratory Medicine were included in this study. 23 were women and 13 were men, with a mean age of 51.7 years. The average duration of asthma was 77.0 months. All patients had mild-to moderate asthma. Acoustic and aerodynamic analyses were performed and the movements of the vocal cords were examined by videolaryngostroboscopy (VLS). Voice Handicap Index (VHI) and GRABS scales were used for subjective evaluations. Results: 50% of patients suffered from dysphonia and FO was 119.3${\pm}$23.7 Hz in male and 198.2${\pm}$18.4 Hz in female patients. There were no significant differences in average shimmer and NHR between females (4.90${\pm}$2.95% ; 0.1O${\pm}$0.04 dB) and males (4.64${\pm}$2.45% ; 0.20${\pm}$0.15 dB). However, the value of jitter was greater for females (2.60${\pm}$1.92%) than for males (1.21${\pm}$0.84%). The VHI score was above the normal limit in 35%, and VLS findings were shown diverse abnormality in 89% asthmatics from mucosal change to hyperfunction of supragottis and contact granuloma. But duration of illness and steroid dose did not correlate with these findings. Conclusion: Subjective and objective abnormality was shown in more than 50% of asthmatic patients. We suggest that persons who suffer from asthma should be examined for possible voice disorders by laryngologist. Additionally, appropriate medical care and voice therapy should be provided for those who have voice disorders associated with asthma.

• 대한후두음성언어의학회지
• /
• 제28권2호
• /
• pp.118-122
• /
• 2017

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

• 대한후두음성언어의학회지
• /
• 제26권1호
• /
• pp.25-33
• /
• 2015

Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.