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A Study of Optimized MRI Parameters for Polymer Gel Dosimetry (중합체 겔 선량측정법을 위한 최적의 자기공명영상 변수에 관한 연구)

  • Cho, Sam-Ju;Chung, Young-Lip;Lee, Sang-Hoon;Huh, Hyun-Do;Choi, Jin-Ho;Park, Sung-Ill;Shim, Su-Jung;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.23 no.2
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    • pp.71-80
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    • 2012
  • In order to verify exact dose distributions in the state-of-the-art radiation techniques, a newly designed three-dimensional dosimeter and technique has been took strongly into consideration. The main purpose of our study is to verify the optimized parameters of polymer gel as a real volumetric dosimeter in terms of the various study of MRI. We prepared a gel dosimeter by combing 8% of gelatin, 8% of MAA, and 10 mM of THPC. We used a Co-60 gamma-ray teletherapy unit and delivered doses of 0, 2, 4, 6, 8, 10, 12, and 14 Gy to each polymer gel with a solid phantom. We used a fast spin-echo pulse to acquire the characterized T2 time of MRI. The signal noise ratio (SNR) of the head & neck coil was a relatively lower sensitivity than the body coil; therefore the dose uncertainty of head & neck coil would be lower than body coil's. But the dose uncertainty and resolution of the head & neck coil were superior to the body coil in this study. The TR time between 1,500 ms and 2,000 ms showed no significant difference in the dose resolution, but TR of 1,500 ms showed less dose uncertainty. For the slice thickness of 2.5 mm, less dose uncertainty of TE times was at 4 Gy, as well, it was the lowest result over 4 Gy at TE of 12 ms. The dose uncertainty was not critical up to 6 Gy, but the best dose resolution was obtained at 20 ms up to 8 Gy. The dose resolution shows the lowest value was over 20 ms and was an excellent result in the number of excitation (NEX) of three. The NEX of two was the highest dose resolution. We concluded that the better result of slice thickness versus NEX was related to the NEX increment and thin slice thickness.

Effects of GnRH Agonist Used for Ovarian Hyperstimulation in Human IVF-ET on the Apoptosis of Preovulatory Follicular Cells (인간 체외수정 및 배아이식에 있어서 과배란 유도 과정에 사용한 GnRH Agonist가 배란 전 난포내 과립 세포의 세포자연사에 미치는 영향)

  • Yang, Hyun-Won;Kwon, Hyuck-Chan;Hwang, Kyung-Joo;Park, Jong-Min;Oh, Kie-Suk;Yoon, Yong-Dal
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.1
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    • pp.55-65
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    • 1999
  • There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-eosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged $11.09{\pm}8.75\;and\;10.33{\pm}4.53$ per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental rate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.

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Consideration on Birth Sex Ratio in Human IVF-ET Program in Korea (인간의 체외수정 및 배아이식술에서 출생 성비에 대한 고찰)

  • Cha, Byung-Hun;Jun, Jin-Hyun;Lee, Jung-Ryeol;Choi, Young-Min
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.33-39
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    • 2010
  • Objective: Birth sex ratio (BSR) with human IVF-ET program is an interesting subject of social and scientific issue but very little information is available in Korea. This study was performed to assess the BSR with IVF-ET and to suggest the effective factors on the BSR. Methods: The national data from 1991~2008 were obtained from governmental Statistics Korea and the delivery data of human IVF-ET program on 2007 and 2008 were provided from the Ministry for Health, Welfare and Family Affairs. The BSR were statistically analyzed according to methods of IVF and to transferred embryos from fresh or frozen-thawed cycles. Results: The BSRs of Korean populations were over 1.10 up to 2002, and then it declined and maintained to 1.06 as balance BSR on 2007 and 2008. In human IVF-ET program, the BSRs were 1.07 on 2007 and 1.06 on 2008, respectively. Conventional IVF on 2008 showed the highest BSR as 1.10, and ICSI the lowest on 2008 as 1.01. There was no significant difference of BSRs related to the methods of in vitro fertilization and the feature of transferred embryos. Conclusion: The BSR of Korea showed 1.06~1.07 as normal and balanced state on 2007 and 2008 both general populations and human IVF-ET program. To the best of our knowledge, this is the first study to evaluate the BSR of human IVF-ET in Korea. There is a need to expand the further studies for national statistics and influencing factors on the BSR with IVF-ET.

The Comparison of Pregnancy Outcomes between Elective Two and Three Cleavage-state Embryos Transfer in Fresh IVF-ET (체외수정술시 난할단계 배아 2개와 3개를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Won, Hyung-Jae;Lee, Woo-Sik;Han, Ji-Eun;Kim, A-Ri;Kim, You-Shin;Seok, Hyun-Ha;Yoon, Tae-Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.65-72
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    • 2010
  • Objective: To compare the respective pregnancy outcomes of cycles undergoing elective two cleavage-stage embryos transfer (2ET) and three cleavage-stage embryos transfer (3ET) in fresh in vitro fertilization and embryo transfer (IVF-ET) program. Methods: We conducted a retrospective matched case control study that included 100 women with 2ET and 100 women with 3ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and cycle characteristics. All of transferred embryos in both groups had good qualities. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with 2ET and 3ET groups were not statistically different; implantation rate (41.0% vs. 35.3%), positive pregnancy rate (58.0% vs. 60.0%), clinical PR (55.0% vs. 59.0%), ongoing PR (51.0% vs. 55.0%), respectively. However, the 3ET group showed significantly higher multiple pregnancy and triplet pregnancy rates (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036, respectively). Conclusion: In women with favorable conditions and good quality embryos undergoing IVF, 2ET can get pregnancy outcomes comparable to those of 3ET and reduce multiple pregnancy (especially, triplet pregnancy).

Formation of Liquid Crystalline with Hydrogenated Lecithin and Its Effectiveness (수소첨가레시친을 이용한 액정 젤의 형성과 보습효과)

  • Kim, In-Young;Lee, Joo-Dong;Ryoo, Hee-Chang;Zhoh, Choon-Koo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.159-165
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    • 2004
  • This study described about method that forms liquid crystal gel (LCG) by main ingredient with hydrogenated lechin (HL) in O/W emulsion system. Result of stability test is as following with most suitable LCG's composition. Composition of LCG is as following, to form liquid crystal, an emulsifier used 4.0wt% of cetostearyl alcohol (CA) by 4.0wt% of HL as a booster. Moisturizers contained 2wt% of glycerin and 3.0wt% of 1,3-butylene glycol (1,3-BG). Suitable emollients used 3.0wt% of cyclomethicone, 3.0wt% of isononyl isononanoate (ININ), 3.0wt% of cerpric/carprylic triglycerides (CCTG), 3.0wt% of macademia nut oil (MNO) in liquid crystal gel formation. On optimum conditions of LCG formation, the pHs were formed all well under acidity or alkalinity conditions (pH=4.0-11.0). Considering safety of skin, pH was the most suitable 6.0${\pm}$1.0 ranges. The stable hardness of LCG formation appeared best in 32 dyne/$\textrm{cm}^2$. Particle of LCG is forming size of 1-20$\mu\textrm{m}$ range, and confirmed that the most excellent LCG is formed in 1-6$\mu\textrm{m}$ range. According to result that observe shape of LCG with optical or polarization microscope, LCG could was formed, and confirmed that is forming multi -layer lamellar type structure around the LCG. Moisturizing effect measured clinical test about 20 volunteers. As a result, moisturizing effect of LCG compares to placebo cream was increased 36.6%. This could predicted that polyol group is appeared the actual state because is adsorbed much to round liquid crystal droplets to multi-lamellar layer's hydrophilic group. It could predicted that polyol group is vast quantity present phase that appear mixed because is adsorbed to round liquid crystal to multi-lamellar layer's hydrophilic group. This LCG formation theory may contribute greatly in cosmetics and pharmacy industry development.

Performance Status of Sanitary Management of School Food Service in the Jeonnam Area (전남지역 학교급식의 위생관리 실태)

  • 고무석;정난희;이전옥
    • Korean Journal of Human Ecology
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    • v.7 no.1
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    • pp.51-67
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    • 2004
  • This study analyzed the effects of nutrition technicians' hygiene education on cooking workers' performance of hygiene management in order to ensure the security of school meals. The situation of cooking workers' disposition in subject schools was elementary school(51.1%) and middle school(48.9%) and the type of meals was rural area type(54.2%), urban type(36.5%). and island and isolated area type(9.3%). The methods of meals management were single cooking(88.2%) and joint cooking and management(11.8%). The type of distributing meals was distributing in a dining room(93.5%), in a classroom(3.7%), and in both dining room and classroom(2.8%). Nutrition technicians' employment form included regular(53.5%) and daily(88.2%). Their education was junior college graduate(50.2%), university graduate(44.8%). and graduate school students(5.0%). Cooking workers' employment form included daily(88.2%) and regular (11.1%). suggesting that most were regular. Most cooking workers(77.4%) had at least high school certificate. Regarding the situation of cooking workers' disposition in subject schools, the number of student per one cooking worker was found as 91-120(37.2%), 61-90(22.6%). 60 and under(21.l %). 121-15006.7%). and 151 and over(2.5%). Cooking workers' level of performance of hygiene management was post-working stage(66.37/75 marks), pre-working stage(64.22/75 marks). and working stage(20.34/25 marks), The counting of meals articles in a pre-working stage(20.34/25 marks). temperature and required time in a working stage(18.78/25 marks), and machinery equipment and hygiene in a pre-working stage(21.40/25 marks) showed lowest of performance, which suggest poor service of hygiene. Cooking workers' performance of hygiene management by working stage showed the significant difference with school class(p<.001), type of schools with meals(p<.05). state of cooking workers' employment(p<.001), and cooking worker's disposition(p<.05). A working stage showed the significant difference with type of schools with meals(p<.05). A post-working stage showed the significant difference according to type of schools with meals(p<.05), and the methods of meals management(p<.05), and cooking workers' disposition(p<.05). In the execution of hygiene education, individual hygiene was highest(94.8%), followed by the management of machinery equipment and tools(89.7%), food poisoning and microorganism(94.7%), and the method of food treatment(76.4%). A yearly plan of hygiene education included established(83.9%) and not established(l6.1%). Regular education included not executed(25.1%), 2-3 times a month(l6.1%), and more than 4 a month(4.0%) and occasional education was not executed(57.0%), 1-3 times a month(26.3%), and more than 4 a month(l5.7%). In the methods for hygiene education, oral education(95.7%) was used most, followed by demonstration(10.5%), poster/photo(10.5%), video/slide(3.7%), and computer(3.7%). Frequency of improvement and complement of hygiene education included once a month(56.3%), once a year(20.7%), by quarter(l1.5%), and every six months(1l.5%). Newspaper was used most in materials of hygiene education, followed by internet, TV, nutrition technician's reeducation, information exchange between members, educational office's training, and reference book, and educational office's material. and symposium. Cooking workers' assessment of the effect of hygiene education was conducted through observation(56.8%), check table(l5.2%), question(l4.0%), and examination(14.0%). The reason of cooking workers' low level of performance included habitual custom(53.9%), lack of understanding(20.4%), overwork(l4.6%), and lack of knowledge(l1.l%) and the reason of difficulty in hygiene education included lack of time(55.3%), lack of understanding(27.6%), lack of knowledge and information(8.7%), and lack of budget(48.0%).

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Untersuchungen iiber Blutenknospenbildung bei Ribes nigrum L. (리베스(Ribes nigrum L. var. 'Rosenthals Langtraubige Schwarze') 식물의 화아분화에 관한 연구)

  • Yang, Deok Cho
    • Journal of Plant Biology
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    • v.27 no.3
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    • pp.179-189
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    • 1984
  • Durch vergleichende Untersuchungen von Ribes nigrum L. var. 'Rosenthals Langtraubige Schwarze' zwischen $prim\"{a}rem$ und $sekund\"{a}rem$ Jugendstadium (P.J. und S.J.) eine vertiefte Einsicht in die beiden zeitlich unterschielich langen $Entwicklungsabl\"{a}ufe$ zu bekommen und auf diese Weise bessere Ansatzpunke $f\"{u}r$ die Regulierung der $Bl\"{u}tc-nknospeninduktion$ zu gewinnen, war das Ziel vorliegenden Untersuchungen. Diese Untersuchungen $f\"{u}hrten$ zu den flogenden Ergebnissen: Die Dauer der Jugendphase von Ribes nigrum L. betrug bei den P.J.-Pflanzen ca. 7 Monate, bei den S.J.-Pflanzen ca. 5 Monate. Die $Bl\"{u}hreife$-(Ripeness to flower)-setzte bei den P.J.-Pflanzen erst beim 20. Nodium ein, bei den S.J.-Pflanzen bereits beim 5. Nodium. Das $f\"{u}hrte$ dazu, da${\beta}$ bei gleicher Nodienzahl die P.J.-Pflanzen weniger $Bl\"{u}te-nknospen$ angesetzt hatten als die S.J.-Pflanzen. Die erste $Bl\"{u}tenknospendifferenzierung$ setzte bei den P.J.-Pflanzen in der oberen Triebmitte etwa am 30. Nodium ein, beiden S.J.-Pflanzen bereits in der unteren Tricbmitte etwa am 20. Nodium. Bie den P.J.-Pflanzen waren die untersten 20. Nodien immer steril, $w\"{a}hrend$ bei den S.J.-Pflanzen $h\"{a}uflgsten$ an dem ersten Nodium $\"{u}ber$ der Basis fertil waren. In allen Versuchen hat sich gezeigt, da${\beta}$ der Wachstumsabschlu${\beta}$ -(Bildung einer Terminal Knospe)-, der bei Ribes nigrum L. durch Kurztag eingeleitet wird, bei den P.J.-Pflanzen langsammer als bei den S.J.-Pflanzen erfolgt. Dies $f\"{u}hrt$ dazu, da${\beta}$ die Pflanzen der $sekund\"{a}ren$ Jugendphase auf die photokybernetischen Stimulation empfindlicher reagieren als die der $prim\"{a}ren$ Jugendphase. Alle untersuchten Versuchsdaten $f\"{u}hren$ zu dem Schlu${\beta}$, da${\beta}$ die Wurzelgibberelline $(GA_n)$ keinen Einflu${\beta}$ auf die $Jugendsterilit\"{a}t$ ($Basissterilit\"{a}t$) haben. Aus den Untersuchungen geht hervor, da${\beta}$ die induktive Ma${\beta}$nahme zur Beschleunigung der $Bl\"{u}tenknospenbildung$ $f\"{u}r$ eine $Z\"{u}chtungsselektion$ erst dann eingesetzt werden sollen, wenn die P.J.-Pflanzen mehr als 20 Nodien ausgebildet haben.

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An Experimental Study on the Excellences of Nurses′ Communication Method upon Psychiatric Patient′s Response. (간호원의 의사소통방법이 정신병환자 반응에 미치는 영향에 대한 실험적 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.78-92
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    • 1974
  • It is the purpose of this study to make clear the way in which people can lead a more desirable human life, that is, to ascertain the method of achieving therapeutic change through transaction between nurses and psychiatric patients. The various problems proposed by th9 above-stated aims of study can be shown, such as: What kind of influences does the method of a nurse′s communication have upon the response of psychiatric patients? 1) What are the general methods of communication used by the nurses? 2) Are there any differences between the control group and experimental group in the patients′ "Child" response? 3) Are there any differences between the control group and experimental group in the Patients "Adult" response? 4) What is the most desirable method of communication for therapeutic change in the patients? In an effort to solve the above questions this study attempted and managed to draw a random sampling of 200 patients being accommodated in the National Mental Hospital by dividing them into two groups, experimental groups and control groups, and recording the transactions between nurses and patients. In the course of carrying,: out this study, the experimental group was interviewed by the nurses specially trained In the P.A.C theory. and the control group interviewed at random by the nurses with no special training in communication. Further, the communication between nurses and patients in a free, relaxed atmosphere was allowed only for 15 minutes, whereupon the nurses were requested to make process-recording according to her memory of nurse patient transaction. The process-recording which recorded a series ol transactions between the nurses and the patients was analyzed according to Berne and Harris′transactional Analysis Standard. Through this standard, the writer of this study examined the significance of difference to compare the transactions brought forth between the experimental group and the control group. The following is a summary of the study which the writer of this thesis undertook. Hypothesis to The method of communication which the nurses usually apply to the patients will be higher in "Parent" than in "Adult". The communication which the nurses carried out in the control group turned out to be not significant between "Adult" and "Parent" Accordingly hypothesis 1. carne to be rejected. Hypothesis 2. The patients "Adult" response will be higher in the experimental group than in the control group. According to the result of a CR examination, as the communication showed a significant difference on P〈.01 level′ hypothesis 2 became affirmative. Hypothesis 3. The patients′"Child" response will be higher in the control group than in the experimental group. Hypothesis 3 proved affirmative since it showed an significant degree on P〈.01 level according to the result of a CR examination. Hypothesis 4 "Adult" response of the patient will be higher in frequency by nurses′"Adult" stimulus than nurse′s "Parent" stimulus Chi-square examination revealed significant difference on P〈.05 level. Hypo. 4 is affirmed. The following conclusions are drawn out based on the result of this study. 1) The generally used method of communication stimulus used by nurses for patients proved to be "Adult" and "Parent" in similar proportion. 2) The group in which the nurses could increase the patients "Adult" response proved to be higher in the experimental group than in the control group. Therefore, the communication (or stimulus) which has been applied in the experimental group can be said to be possible method of achieving therapeutic change. 3) Since the patients′"Child" response were higher in the control group than in the experimental group the communication method used In the control group was suggested as the less agreeable method of achieving therapeutic change than that used in the experimental Group. 4) "Adult" response of patient was elicited in significantly greater percentage when the "Adult" stimulus was used by the nurse. Therefore the most desirable method of-communication to give therapeutic change definitely was shown to be the "Adult" stimulus. Recommendations for further studies are as follows: 1) Studies on nurses′role perception in nurse-patient relationships. 2) Studies on patients′response to the method of communication used by nurses according to variables such as sex, social status, educational background, state of health. 3) Application of T.A, method to various groups of patients. 4) Study of various methods to improve student skill in use of process recording.

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Ethnosientific Approach of Health Practice in Korea (한국인의 건강관행에 대한 민속과학적 접근)

  • 김귀분;최연희
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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A Study on the IADL Affecting Subjective Health Index of the Aged in Some Area (일부지역(一部地域) 노인(老人)들의 주체적(主體的) 건강수준(健康水準)에 영향을 미치는 IADL에 관한 연구(硏究))

  • Kim, Keun-Jo;Park, Heung-Ki;Koon, Hyeok-Su;Bae, Soo-Chan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.29-50
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    • 2001
  • This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

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