• 대한통합의학회지
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• 제10권2호
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• pp.13-25
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• 2022

Purpose : This study compared the cost-effectiveness ratio of physical therapy in health centers and home physical therapy, two physical therapy methods for home-bound stroke patients, and clarified the economic validity regarding the effect of home physical therapy. Methods : To measure and compare the cost and effectiveness of the two physical therapy methods for stroke patients, subjects were recruited based on in-hospital and home physical therapy. Among the entire data collected, 82 and 90 participants were selected for in-hospital and home physical therapy, respectively. To measure costs, regarding both in-hospital and home physical therapy, direct cost and indirect cost for patients, family, medical institutes, and the government were measured. In addition, activities of daily living were measured in both methods to measure their effectiveness. Through collected data, the cost-effectiveness and incremental cost-effectiveness ratios were analyzed. Results : Based on the analysis of cost-effectiveness, home physical therapy showed lower cost-effectiveness than in-hospital physical therapy. Furthermore, the incremental cost-effectiveness ratio also showed a difference, which implied home physical therapy could have high effectiveness compared to cost. Conclusion : Based on these results, home physical therapy could be considered as an alternativeto other methods of physical therapy, for home-bound stroke patients. In addition, the result of thisstudy contribute by providing evidence that home physical therapy offers economic benefits and canbe more effective in treating home-bound patients when policy decisions are made to establish a home physical therapy system.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.48-54
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• 2024

Background: Promoting patients' safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI). Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors. Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient's medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge. Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay. Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.

• 성인간호학회지
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• 제12권2호
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• pp.209-221
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• 2000

This longitudinal study examines the burdens and related factors for stroke patient's primary family caregivers. Sixty-one patients treated for stroke at a general hospital in Chung-nam province and family member caregivers participated in this study from July 28, 1998 to August 1, 1999. Family caregivers' burdens were assessed by the burden scale originally developed by Zarit(1980) and Novak & Geust(1989) and modified by Oh's(1993) for use in Korea. The burden scale instrument consists of five subscales.: financial burden, social burden, physical burden, dependency burden, and emotional burden. Repeated ANOVA and Stepwise multiple regression were used in the data analyses. The results were as follows: The burden mean score was 3.23 in the hospital, 3.26 after hospital release, and 3.27 in the home environment. In the hospital, a patient's degree of cognition, and social support for family caregivers were significant factors affecting the sense of burden felt by family caregivers. After hospital release, the significant factors affecting the sense of burden were the degree to which stroke patients could participate in daily living activities, social support for family caregivers, and changing to a second caregiver. In the home environment, the most significant factor affecting the sense of burden was social support for family caregivers.

• 기본간호학회지
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• 제8권1호
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• pp.81-94
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• 2001

The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.

• 대한간호학회지
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• 제30권3호
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• pp.595-605
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• 2000

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.

• 대한가정학회지
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• 제29권3호
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• pp.85-98
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• 1991

To investigate dietary habits and health and nutritional status of the elderly with cerebrovascular disease(CVD), 31 hospitalized patients and 28 old people who had experienced stroke and were living at home were interviewed for the dietary habits and drinking and smoking habits. Their blood pressure and triceps skinfold thickness were measured and biochemical assessment of blood samples were conducted. The results were compared with those from 30 healthy elderly. Ca Index reflecting ca intake and intake of dietary fiber were significantly lower in the patient elderly groups than in the healthy elderly. Cholesterol intakes were not significantly different among the groups. Although salt intakes were almost similar among the groups, patient elderly tended to like salty taste as compared to the healthy elderly. Systolic and diastolic blood pressures of the patient elderly were significantly higher than those of the healthy elderly. Triceps skinfold thickness and serum total protein and albumin were significantly lower in patient groups than the healthy elderly. Serum cholesterol and hemoglobin concentrations were not different among groups. Among the above variables only Ca index was inversely correlated with blood pressure significantly.

• 재활간호학회지
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• 제3권1호
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• pp.108-117
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• 2000

Stroke is one of the leading causes of death in Korea. Because of their sequelae, strokes are categorized as a sudden-onset, constant course chronic illness which needs continuous efforts for rehabilitation. Unfortunately, there are few community based rehabilitation program for post-stroke patients who stay at home. The authors developed a community based selp-help management program for post-stroke patients to enhance their rehabilitation process. The program consists of five sessions and each session contains health education. ROM exercise, ADL training, and stress management like foot reflexology. A professor and two graduate students of nursing college coordinated the program. To test the effects of the program we conducted a 5 week program to the 10 conveniently selected post-stroke patients who were living in Kang-buk district of Seoul. The Questionnaires about ADLs, IADLs, depression and life satisfaction were asked to the all subjects before and after program. The hand grisp power and muscle strength of four limbs were measured at the end of each sessions. The analysis of data revealed that the program was effective to increase the ADLs, IADLs, and muscle strength and to decrease the depression levels of subjects. However, there was no significant difference between pre and post hand grisp power and life satisfaction. Because the program was effective to Improve the physical and psycholocial function of subjects, we suggest continual development and Implementation of community based self-help management programs.

• 대한물리의학회지
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• 제17권4호
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• pp.133-139
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• 2022

PURPOSE: The purpose of this study was to investigate the effects of a group exercise program with competitive games on balance in chronic stroke patients. METHODS: The subjects were chronic stroke patients living at home after their discharge from the hospital. A total of 32 subjects were divided into two groups. The experimental group performed a group exercise program with competitive games, and the control group performed individual exercises. The exercise program duration was one hour, and it comprised 10 minutes of stretching, 40 minutes of the main exercise, and 10 minutes of stretching at the end. The experimental group was divided into two teams of 8 players each and played competitive games (transfer a gym ball to another person, relay 10 m walking and return, transfer an object to the next person using both arms while sitting). The control group performed an arm/trunk exercise for 15 minutes and gait training for 25 minutes. These exercises were conducted twice a week (4 weeks). The Berg Balance Scale (BBS) and timed up-and-go (TUG) tests were performed to confirm the change in balance. RESULTS: In the experimental group, BBS showed a significant increase (p < .05) and TUG showed a significant decrease (p < .05). In the control group, there was no statistically significant change in the BBS. However, the TUG showed a significant decrease (p < .05). The BBS and TUG both showed statistically significant differences (p < .05) in the between-group comparison of the change in pre-post intervention values. CONCLUSION: A group exercise program with competitive games to improve the balance ability for fall prevention in chronic stroke patients could be used as a good intervention method.

• 재활치료과학
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• 제9권3호
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• pp.7-21
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• 2020

목적 : 본 연구는 뇌졸중 환자와 노인 환자를 대상으로 퇴원 시기에 이루어지는 평가도구에 대한 체계적 문헌고찰을 통해 평가 항목과 평가도구들을 분석하여 효율적인 퇴원계획을 위한 기초자료를 제공하고자 한다. 연구방법 : 문헌 선정은 PubMed, Medline Complete(EBSCOhost), Scopus를 사용하여 2009년 1월부터 2018년 12월까지의 온라인 데이터에 등록된 연구를 대상으로 최종 22편의 연구를 선정하였고, 연구 설계 및 퇴원 시 주요 평가영역, 하위영역, 평가도구들을 분석하였다. 결과 : 선택된 연구들의 연구 설계 형태는 기술적 연구가 13편(59.2%)으로 가장 많았다. 퇴원 시 평가 영역은 의학적 상태, 일상생활활동, 삼킴 기능, 감각, 이동성, 인지·지각, 의사소통, 감정상태, 가정환경, 환자의 지식과 퇴원을 위한 준비, 사회적지지, 안녕감 등 12개 영역으로 나타났다. 평가 영역에 따라 사용된 평가도구를 분석한 결과, 가장 높은 빈도의 사용을 보이는 평가도구는 일상생활활동을 평가하는 Barthel Index, Functional Independence Measure, 안녕감을 평가하는 Short Form Health Survey, 이동성을 평가하는 Timed Up and Go test 등으로 나타났다. 결론 : 본 연구를 통해 뇌졸중, 노인 환자의 퇴원 시 이루어지는 다양한 평가 영역과 평가도구의 사용과 제한적이나 여러 영역을 포괄하는 평가도구들을 확인할 수 있었다. 이는 뇌졸중 환자의 퇴원 시 고려되는 평가 영역과 효과적인 평가도구의 선택을 돕고 적절한 퇴원계획 중재와 제안을 위한 포괄적인 평가도구의 개발의 기초자료가 될 것이다.