• Title/Summary/Keyword: patient motivation

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Impact of Patients' Level of Participation in Rehabilitation on Functional Outcome in Patients With Stroke (뇌졸중 환자의 재활참여가 기능회복에 미치는 영향)

  • Won, Jong-im
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.63-69
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    • 2020
  • Background: Stroke recovery is a long and complex process. Successful stroke recovery seems to be strongly associated with patients' high motivation and committed participation. Patients' motivation is a key determinant of successful rehabilitation outcomes, but it is difficult in defining and measuring. Patients' participation is defined as the degree or extent to which subjects take part in rehabilitation activities and can be measured by observable behavior. Objects: The purpose of this study was to investigate the impact of patients' level of participation in rehabilitation on functional outcomes in patients with stroke. Methods: Forty post-stroke inpatients participated in this study. The level of rehabilitation participation was measured by the Hopkins Rehabilitation Engagement Rating Scale (HRERS). Other measures used for the evaluation were the Rivermead Mobility Index (RMI) and Korean version of the Modified Barthel Index (K-MBI). Overall measurements were made at early intervention and late intervention. Spearman correlation and multiple regression were used to measure the relationships between HRERS, RMI, and K-MBI. Results: The correlation found between HRERS total scores at early intervention and RMI total scores of late intervention was above moderate (r = 0.607, p < 0.01). RMI total scores at early intervention (p < 0.000), HRERS total scores at early intervention (p < 0.001), and disease duration (p < 0.003) were significant predictors of RMI total scores at late intervention. Conclusion: The level of participation at early intervention was associated with improvement in mobility. The level of mobility at early intervention, disease duration, and patients' participation at early intervention were important determinants of functional outcome. These findings suggest that patients' participation should be encouraged in order to achieve successful stroke recovery.

Effects of and barriers to hospital-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

  • Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
    • Physical Therapy Rehabilitation Science
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    • v.9 no.2
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    • pp.82-89
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    • 2020
  • Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

Factors Affecting the Self-Management of Adolescents with Type 1 Diabetes Mellitus based on the Information-Motivation-Behavioral Skills Model (제1형 당뇨병 청소년의 자기관리 영향요인: 정보-동기-행동기술 모델을 기반으로)

  • Lee, Hooyun;Choi, Eun Kyoung;Kim, Heejung;Kim, Ho-Seong;Kim, Hee-Soon
    • Child Health Nursing Research
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    • v.25 no.2
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    • pp.234-243
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    • 2019
  • Purpose: The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetes-related attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation-behavior skills model. Methods: Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children's hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05. Results: The mean score of self-management in adolescents with type 1 diabetes mellitus was $61.23{\pm}10.00$ out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (${\beta}=.504$, p<.001) and family support (${\beta}=.188$, p<.001) were significant predictors of self-management. Conclusion: It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

Quality Improvement Activity in Hospitals and Its Acceptance among Hospital Personnels (의료 질 관리 활동에 대한 병원종사자들의 태도와 인식)

  • Hwang, Jeong-Hae;Cho, Sung-Hyun;Kim, Chang-Yup;Seo, Juag-Don;Han, Man-Chung;Lee, Jeong-Ye
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.86-97
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    • 1997
  • Background : It is a primary goal for hospital personnel to improve the quality of patient care. In Korea the concept of quality assurance has been spread over the last five years. Many hospitals have implemented quality assurance programs that fit their own philosophy and needs. As a result, they are supposed to have different experiences and attitudes toward quality assurance. To investigate their diversity will be helpful to have a direction to the future and to enhance the quality assurance activities in Korean hospitals. Objectives : The aim of this study is to obtain information about hospital personnel's attitude and opinion toward quality assurance in hospitals. Methods : A questionnaire was developed which consisted of five parts; the general characteristics of respondent, the concepts of quality assurance, need for quality assurance program, current status of quality improvement activities, and participation in programs. Using the registry of Korean hospitals, 102 hospitals with more than 400 beds were selected. Questionnaires were mailed to hospital staffs of each hospital; top managers, clinical department heads, registered nurses, medical recorders, and administrators. Results : Of 2038 questionnaires sent, 877 were returned, giving response rate of 44%. Most respondents(70%) regarded quality assurance as efforts to provide patient with care in highest quality and to improve effectiveness or resource utilization. Ninety-nine percent of respondents agreed to need for quality assurance in their hospitals. There were current quality improvement programs implemented in the department of 553 respondents(62%), and most of the(85%) have participated in at least one program. Lack of motivation was pointed out as a barrier to implement the programs. Conclusion : Although most respondents have known of the concept and need for quality assurance, this study suggests that education and motivation of hospital personnel be needed to activate the quality assurance programs in hospitals.

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Dynamic Developmental Factors and their Problem Solving of Patients that Abuse Marihuana (마리화나 남용환자의 역동적인 발달요인과 문제해결)

  • 원정숙
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.105-116
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    • 1974
  • This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

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A Study on Patient Experience Assessment of Appropriate Outpatient Medical Services of a University Hospital (일 대학병원 외래환자의 적정진료에 대한 환자경험평가 연구)

  • Her, Eun Kyoung;Ahn, Sang-Yoon;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.351-357
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    • 2019
  • This study was conducted to evaluate outpatient experiences of a general hospital and help identify the medical service status experienced by the patients in the overall process of outpatient care, and analyze the major factors influencing patient experience and perception. A total of 100 patients having more than 2 outpatient clinic visits at a university hospital from May 14, 2018 to May 28, 2018, were selected to participate in the survey, comprising 60.0% females and 40.0% males. Considering age, majority belonged to the >60 years old age group (53.0%) as compared to <59 years (47.0%). "Hospital is close by" was the highest motivation to visit the hospital (42.0%), followed by "Medical staff is skilled" (36.0%), "Recommended by another hospital" (7.0%), and "Recommended by people" being the lowest (1.0%). Taken together, the results of this study can be used as basic data to identify the issues for providing better patient-centric medical services, and to formulate plans for creating medical services that meet the patient needs and differentiated medical services.

Effects of a Standardized Patient Simulation Program for Nursing Students on Nursing Competence, Communication Skill, Self-efficacy and Critical Thinking Ability for Blood Transfusion (표준화환자 시뮬레이션 실습교육이 간호학생의 수혈 간호수행능력, 의사소통능력, 자기효능감과 비판적 사고능력에 미치는 효과)

  • Joo, Ga Eul;Sohng, Kyeong-Yae;Kim, Hee-Ju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.1
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    • pp.49-58
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    • 2015
  • Purpose: This study was conducted to identify the effects of a standardized patients (SP) simulation program for nursing students on nursing competence, communication skill, self-efficacy and critical thinking ability for blood transfusion. Methods: A nonequivalent control group non-synchronized design study was used and included as participants 96 junior nursing students at C University. The SP group (n=48) participated in the teaching class using a SP, while the control group (n=48) received conventional practice education. The outcome measurements were nursing competence, communication skill, self-efficacy, and critical thinking ability for transfusion. Results: Nursing competence, communication skill, self-efficacy, and critical thinking ability improved for students in both groups after training ($2.01{\leq}t{\leq}13.03$, p<.05). Self-efficacy showed greater improvement in students in the SP group compared to the control group (t=3.36, p<.001). Conclusion: SP simulation practice may be more effective in enhancing self-efficacy than that of conventional practice education. Whether self-efficacy will contribute to enhancing learning motivation for nursing students needs further examination.

Occupational Therapy Students Perceive Research on Image (작업치료과 학생들이 지각한 작업치료사의 이미지의 대한 연구)

  • Song, Minok;Jang, Aram;Jung, Myeongjin;Hong, Miae;Jang, Chel
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.3
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    • pp.97-109
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    • 2013
  • Purpose : The purpose of this study work for the therapy and how students perceive the occupational therapist was to find out how. Method : The subjects in Busan and Kyungnam located in three two-year colleges and four-year clinical experience of two college students completed work therapeutics were expressed any research to understand the purpose of those who agreed to participate in the survey responded to the 175 people working Therapeutics two, three, four grades were included in the study. Result : 1. Education according to the image of the occupational therapist in grades four-year professional, the value and worth, the patient understand the position was higher in order. 3-year sophomore highly skilled in, the patient understand the position, sincerity was higher in order. 2. Gender occupational therapist who specializes in images for men, the value and worth, high practician was higher in women who were professional, the value and worth, helfer as high. 3. Theory of motivation based on the value of occupational therapists and rewarding images aptitude and interest, high practician, attractive, intellectual was in order. Entrance examination scores as a professional party, value & worth, abuse of authority ceremony was in order. 4. Image by Place of Practice Rehabilitation Hospital occupational therapist who specializes in, high practician, intellectual was in order. Care in the hospital and rewarding value, the professional character, high practician was in order. Hospital and rewarding the value, who specializes in, hepfer was in order. University Hospital who specializes in, the value and worth, Attractive was in order. Conclusion : It had revealed that occupational image perception of occupational therapy student was positive.

A Survey on Opinions on the DRG Reimbursement System (DRG 지불제도 시범사업에 대한 평가 및 개선방안 연구 - DRG 시범사업 참여기관 의견을 중심으로 -)

  • Lee, Sun-Hee;Choi, Kui-Son;Chae, Yoo-Mi;Jo, Heui-Sug
    • Korea Journal of Hospital Management
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    • v.5 no.2
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    • pp.78-99
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    • 2000
  • Objectives: The purpose of this study was to evaluate the opinions of hospital managers on DRG pilot study. Methods: Managers of 800 hospitals which had participated in DRG pilot study during the period 1997-1999, were requested to respond to structured self-administerd questionnaire. The questionnaire was composed with six categories: the motivation and satisfaction for the DRG pilot study, the opinions on the level of unit price, the appropriateness of DRG classification, the change of medical service quality during the pilot study, the patient's complains resulted from DRG system. and the opinions on the nation-wide application of DRG system. Results : Of the 800 subjects, 327(clinic, 210: 25 hospitals, 82 general hospitals, and 16 tertiary hospitals) completed the questionnaire, and the overall response rate was 41%, 121 hospitals(27%) answered that they participated in DRG pilot study because of convenience of claims and 118 hospitals(35%) dissatisfied with DRG system. 251 hospitals(85%) thought that the level of unit price under the DRG system was same as or lower than that of fee-for service. 297 hospitals(92%) responded that DRG classification should be modified and 137 hospitals(47%) experienced deterioration of medical service quality during the DRG pilot study. The 116 hospitals(35%) experienced the patient's complains resulted from DRG system. The 85 hospitals(88%) didn't want nation-wide application of DRG system. Conclusion: Most of the responded managers seemed to have negative opinions on DRG pilot study, even though they had been participated voluntarily. Further studies and extensive evaluations of DRG reimbursement system are needed before nation-wide application.

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Two Cases of Narcolepsy Patient Portraying a Tendency of a Dull Learning Ability and Mistaken as an Idle Student (학습부진 양상을 보이고 나태한 학생으로 오인된 기면증 환자 2 례)

  • Lee, Seung-Hwan;Kim, Sun-Kook;Kim, Leen;Chung, Young-Cho;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.138-143
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    • 2001
  • Sleepiness is associated with many different conditions and, as a neglected topic, it can be the cause of serious psychological and social disadvantages. In the aspect of learning, additional problems may arise from poor progress in school caused by the effect of sleepiness on concentration, memory, and other cognitive functions. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not a rarity, especially in young people. The non-specific nature of early features of narcolepsy, combined with very limited awareness that the condition can start in various ways, leads to many misinterpretations. Misinterpretation of narcolepsy symptoms is not confined to the medical profession. Teachers may well be critical of a student with narcolepsy because of their perception of narcolepsy symptoms as laziness, poor motivation, or difficult behavior and dull learning ability. Inappropriate reactions by parents, teachers, and peers, based on misinterpretation of narcolepsy symptoms or the patient's reactions to them, make a difficult situation worse. Especially in Korea, where schooling is focused on college entrance examinations, the problem is very serious and intensified by inappropriate or delayed diagnosis and treatment. Therefore, psychiatrists should be aware that narcolepsy in young adolescents is not rare and that they need to be familiar with its clinical features in both its classic and less obvious forms. Narcolepsy should be suspected if a adolescent's excessive sleepiness can not be explained in other ways. Therefore, we report on two patients who portray the tendency of dull learning ability and are mistaken as idle students. We diagnosed narcolepsy through polysomnography and multiple sleep latency testing. We treated the students with methylphenidate and pemolin. The students showed improvement in learning ability and were able to adapt better to school.

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