• Journal of Korean Academy of Nursing Administration
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• v.14 no.4
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• pp.421-431
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• 2008

Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.520-532
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• 2003

Purpose: The purpose of this study was to identify the health status and request of community residents. This study is part of development of efficient health life enhancement programs. Methods: The subjects of this study were 586 households in a rural community and well-trained interviewers visited every household in the designated area and individually interviewed heads of households for general information and health service utilization. The data were collected using a questionnaire for seven months from March 25 to September 24, 2002. The data were analyzed using frequency. percentage by SPSSWIN (v 10.0). Results: 1. 58.9% of subjects were above sixty, and 60.8% of them were women. 2. The most serious problems they identified were health problems (45.6%), and the second was(##-was+were) economic problems(22.0%). 3. Almost half of the study population regarded themselves as healthy (46.2%). The types of illness they had were neuralgia, arthritis, hypertension, diabetes, and heart disease. 4. Most of the study population answered that they didn't do anything special for health enhancement. 5. Among medical facilities, hospitals or medical clinics (55.3%) were most commonly utilized when they were sick. 6. The highest request of the subjects was 'Home visiting service (45.4%)', and 'free treatment connected to the service of hospitals' was the second. What they needed most regarding health enhancement programs in health life enhancement centers was 'free health examination (58.2%), and heath education programs (57.7%). 7. As a result of investigating the subjects' demand for nursing services in health life enhancement center, 'the clinical examination' was the most requested, and next was 'blood pressure check', 'emergency treatment', and 'rehabilitation service', in that order.

• Research in Community and Public Health Nursing
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• v.9 no.2
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• pp.280-290
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• 1998

This study was carried out to idenify the health problems and needs of crippled persons in order to develop a community based rehabilitation service program through public health center. Information on health problems and needs were obtained from 120 crippled persons staying at home by questionaire and a measuring ADL. The results were summarized as follows 1. Among 120 subjects, male crippled (70.3%) outnumbered female crippled (29.7%). Many crippled persons belonged to the 40-49 age group (33.6%) while others were over 60 years (17.4%). There were 36.8% crippled persons with an elementary education, 26.5% had completed high school, 14.5% had completed middle school. 31% of the crippled persons were employed but most of them had unskilled jobs. 80% of the respondents replied that their monthly income was under 800,000 won. 2. The major causes of their handicap were due to acquired factors(92%) such as accidents, in fectious & communicable diseases and chronic diseases rather than congenital factors(8%). Crippled persons who belong to the first grade of disabilities were 14.8%, the second grade 35.7%, the third grade 21.7%, the forth grade 12.2%, the fifth grade 12.2% and the sixth grade 3.5%. 3. This study measured the degree of the ADL of crippled persons by a modified Barthel Index including 11 items. 73.5% of them were fully independent, 8.5% required minimal help, 2.7% required moderate help, 6.0% required substantial help and 9.4% were unable to perform task. In response to the 11 items of ADL, crippled persons required more help in stair climbing, ambulation and bathing than in other items. 4. In responding to concerning health problems, 10.3% of the subjects replied with incontinence, 8.5% malnutrition, 7.6% fecal incontinence and bedsores 2.6%. Chronic diseases which needs treatment were chronic pain(61.0 %), hypertension(16.5%) and diabetes(16.5%) 5. To the question of what type of rehabilitation services subjects required, chronic diseases management(52.1%) and physical therapy (41.2%) were the highest. The most important social welfare services subjects required were economics support (51.3%) and introductions to job opportunities(42%).

• Journal of Society of Preventive Korean Medicine
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• v.14 no.1
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• pp.37-48
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• 2010

Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.

• 한국노년학
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• v.30 no.4
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• pp.1293-1309
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• 2010

This study is aimed to evaluate the effects of community-based prehabilitation program developed to prevent functional decline in the frail elderly and to provide a basis to practically operate this program in the public health care service. From March to August 2009, 110 frail elderly people were recruited among the registered participants of the home visit program in Korea to perform a prospective randomized community trial. We randomly assigned these people into two groups. One group (n=50) participated in the visiting prehabilitation program for 3 months focusing on improving their muscle strength of upper and lower limbs, walking ability, and balancing. The other group (n=60) underwent our visiting fall prevention program for control. To assess the effectiveness of prehabilitation program, physical functioning (PF) and short physical performance battery (SPPB) were measured for the primary outcomes and also some other indicators: exercise performance, nutritional status, emotional functioning, experience of admission, and events of fall. As a result, significant improvements of geriatric functional status were noticed among the participants. After 3 months, PF increased by 1.3 ± 3.8 points in prehabilitation group and decreased by 1.1 ± 5.4 points in controls (p=.020). SPPB improved by 2.4 ± 2.0 points in prehabilitation group and increased only 0.3 ± 1.5 points in controls (p<.001). Significant effects were also shown in their exercise performance tests and emotional status, the number of multiple falls, and the experience of functional decline after the fall (p .002-.038). Visiting prehabilitation program is safe and effective program for frail older adults. Thus, it is strongly recommended to universally adopt this program to prevent functional decline in the frail elderly.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• 한국노년학
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• v.27 no.2
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• pp.459-472
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• 2007

This research has its purpose of developing a tool to assess the needs of the Korean elderly at home population and to provide adequate services by evaluating their physical, psychological, and socio-environmental aspects. This developed tool is composed of two hundred questions and has the advantage of combined physical, psychological and social environmental situation assessment of the elderly at home. The tool also contains not only the objective view of the professionals, but also the subjective appeals of the elderly at home population so that it can reflect their substantial desires. The assessment tool was developed over 21 months from July, 2004 to March, 2006 and this period can be divided into three different stages. In the first stage, collecting of questions for the desire-focused assessment of the elderly by literature investigation and researching foreign source materials was carried out, and this ultimately developed assessment tool was applied to the long-term care insurance pilot project in the second stage. In this process, we revised some insufficiencies of this tool after we applied to elderly of 250 from the pilot project and other 200 elderly from this research team. For the last stage, the tool was completed by using inquiries of the focused group and the group of professionals to ensure its reliability and validity. In the process of developing the tool, the total of 200 questions under 13 subcategories was selected. The 13 subcategories are basic information, subjective appeals, information of the main helper, use of services, house environment, condition of health, condition of rehabilitation, daily living(ADL, IADL, defecation, assistance), social maintenance, behavioral disability, medical health, living habits, and strength. This tool is on the purpose to assess thoroughly the desires that the elderly at home population has and to provide the best service they need.

• The Journal of Korean society of community based occupational therapy
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• v.7 no.1
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• pp.59-70
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• 2017

Objective : The purpose of this study was to examine the effect of virtual reality-based remote rehabilitation on stroke patients systematically and to look for its effect and how to apply it domestically. Methods : In order to search data, EMBASE and CINAHL database were used. Relevant research used those terms of virtual reality, telerehabilitation, and stroke. A total of 10 studies satisfying the selection criteria was analyzed according to their qualitative level, general characteristics, and PICO method. Results : Based on the selected 10 studies, virtual reality-based telerehabilitation system was applied. Sensory and motor feedback was provided with inputting visual and auditory senses through a video in the home environment, and it stimulated changes in the client's nervous system. Tools to measure the results were upper extremity function, balance and gait, activities of daily living, etc. Those virtual reality-based telerehabilitation method had an effect on upper extremity function and ability of sense of balance in all studies, and on the activities of daily living partially. Telerehabilitation service to make up environmental specificity improved satisfaction of client. That meaned the effect of the intervention to maintain the function. Conclusion : The virtual reality-based telerehabilitation system was applied to upper extremity function, sense of balance, and activities of daily living largely, and it showed that it helped to improve functions through intervention, supervision, and training of therapist in the home environment as well. This study suggests the basis and possibility of clinical application on virtual-reality based telerehabilitation. Additional research is needed to diverse virtual reality intervention methods and the effect of telerehabilitation in the future.