• 제목/요약/키워드: ADL (Activities of Daily Living)

검색결과 418건 처리시간 0.027초

요통환자의 통증행위에 대한 조사연구 (The Pain Behavior of Patients with Back Pain)

  • 이은옥;임난영;김달숙;김순자;한윤복;김주희;김광주;박점희;이선옥
    • 대한간호학회지
    • /
    • 제17권3호
    • /
    • pp.184-194
    • /
    • 1987
  • The purposes of this study were; 1) to gather data relevant to demographic features. major main management practices, and the level of impairment of the activities of daily living (ADL) of patients with back pain, 2) to test the sensitivity of the Korean Pain Rating Scale and the Graphic Rating Scales, and 3) to identify indirect indicators of back pain by analysing pain related-behaviors. The level of pain was measured by Korean Pain Rating Scale(KPRS) and Graphic Rating Scales(GRS) developed by the reserchers. The GRS consists of two dimensions; the pain intensity (sensory) and unpleasantness (affective) measures. Of the 1,650 diagnosed back pain patients, from January 4 through June 30, 1987 by visiting outpatients' clinics of orthopedic and neurosurgical departments at 11 university hospitals in different districts of Korea, 330 men and women patients were self-selected by responding to the mailed questionnaires. The results were summarised as follows: Male exceeded female patients in number and onset of back pain were more prevalent in the age groups of 20s and the 30s. The average duration of suffering from the pain were 11 months, sixty three (19.1%) of the subjects retired from their jobs, one third(36.7%) have teen hospitalized for the treatment of back pain. In two thirds(64.8%) of the cases pain was characterized as lower back pain. The average sleep hour was 6.8 hours per 24 hours and the average rest hour during the day was 3.3 hours. The mean percentage of pain measured by GRS was higher than that of KPRS. The level of sensory intensity as well as the affective level of pain measured by KPRS and GRS were not highly correlated (sensory intensity r=0.4986, affective r=0.5029) which indicated low discriminative power. On the other hand, intercorrelation between sensory and affective dimension measured by KPRS and GRS showed moderate interrelation(r=0.7247; r=0.7899). One-third(32.5%) of the subjects complied with the hospital prescribed treatment while the other one-third(31.5%) depended on self-remedy and traditional practices, and the last one-third did not imply any pain management practices. The following 6 pain-related behaviors such as length of hospitalization, rest hour during day hours, varieties of pain management practice implied, number of pain sites, need for ADL and discomfort accompanied by ADL revealed to be important indicators of back pain. An investigation of sociodemographic features of patients with back pain in a larger context, i.e. with bigger number of respondents is recommended. Tests for construct validity of KPRS, i.e. factor analysis is further recommended.

  • PDF

Analysis on Muscle Activities in the Upper Body of Caregivers according to Drive-Assisting Speeds of a Shower Carrier

  • Ko, Cheol Woong;Cho, Deok Yeon;Bae, Tae Soo
    • 대한인간공학회지
    • /
    • 제32권5호
    • /
    • pp.437-442
    • /
    • 2013
  • Objective: The objective of this study was to investigate the effects of drive-assisting system in a shower carrier on the upper body muscle activities of caregivers through drivability tests. Background: In care facilities, one of the major ADL (Activities of Daily Living) factors is bathing/showering. Recently, bath/shower-assisting equipment is actively being introduced in care facilities to reduce caregivers' muscle burden. In particular, it is desirable to utilize a shower carrier equipped with drive-assisting system to effectively care for the elderly. However, there were few systematic studies on the relationship between muscle activities and drive-assisting speeds. Method: For the drivability tests to study the effects on the muscle activities according to the drive-assisting speeds(corresponding drive-voltages: 0.0V, 2.0V, 2.1V, 2.3V), 6 females in their 40s($43{\pm}4yrs$, $157{\pm}5cm$, and $54.5{\pm}1.5kg$) were selected. To measure muscle activities of caregivers through drivability tests, 7 muscles in the upper body(TM/Trapezius Muscle, DM/Deltoid Muscle, BBM/Biceps Brachii Muscle, TBM/Triceps Brachii Muscle, ECRLM/Extensor Carpi Radialis Longus Muscle, FCUM/Flexor Carpi Ulnaris Muscle, and ESM/Erector Spinae Muscle) were selected. Results: In the TM, muscle activities were decreased as 21% compared to 0.0V, when drive-voltage 2.0V was applied, as 57% by 2.1V, and 62% by 2.3V(p<0.05), whereas 40%, 56%, and 69% of muscles activities were decreased respectively from the DM(p<0.05). Also, from the UL(BBM+TBM+ECRLM+FCUM), muscle activities were decreased by 17% with 2.0V as against 0.0V, by 47% with 2.1V, and 52% with 2.3V, whereas decreases in muscle activities from the ESM were found by 20%, 34%, and 42% respectively by 2.0V, 2.1V, and 2.3V(p<0.05). Conclusion: The muscle activities were decreased in the order of the DM, TM, ESM, and UL. As muscle activities were remarkably reduced as drive voltage were increased, it was expected to reduce the upper body muscle burden on the caregivers when using shower carriers equipped with driving-assist system. Applications: The results from this study can be applied for the development of a shower carrier including other equipment to possibly reduce the muscle burden of the caregivers.

재난 시 노인의 대처행동에 관한 연구 (A Study on the Coping Behavior of Older People in the Warning Phase of Disaster)

  • 정순둘;박현주;최여희;이지현
    • 한국방재학회 논문집
    • /
    • 제8권5호
    • /
    • pp.71-76
    • /
    • 2008
  • 본 연구는 재난에 특히 취약한 노인에게 재난 경고시의 행동 요령과 정보전달에 도움을 줄 수 있는 방안을 모색하기 위하여, 재난 시 경고시간(warning phase) 동안의 노인들의 대처행동을 분석하고 대처 행동에 영향을 미치는 요인을 살펴보고자 하였다. 연구대상자는 2006년 집중호우로 인해 직접적인 피해가 있었던 강원도 인제군과 평창군에 거주하는 60세 이상 노인 130명이었다. 조사결과를 살펴보면, 대부분의 노인들이 자연 징후를 보고 수해를 알게 되었다고 응답하였으며 대처행동을 6단계로 나타내는 Perry & Lindell(1997)'s index를 통해 재난시의 노인들의 대처행동이 높은 수준임을 알 수 있었다. 또한 노인의 일상생활 수행 능력(ADL)과 거주기간이 대처 행동에 영향을 주는 요인인 것으로 나타났는데, 수해 노인들은 ADL이 높을수록 높은 수준의 대처행동을 보였으며, 거주 기간이 길수록 낮은 수준의 대처행동을 보였다. 이러한 결과를 통하여 약 70%의 노인들이 재난시의 대처 행동에 충실하게 따랐으며, 노인들이 재난 시 비협력적이거나 비순응적인 집단이 아니라는 것을 보여주었다. 이는 노인에 대한 신속하고 정확한 경고의 발령과 전달의 중요성을 강조해주는 결과이며, 자연재해에 대한 사전 정보와 지식 전달, 그리고 대피에 대한 인식과 비상시의 대피계획 등에 관한 학습과 훈련의 필요성을 나타내 주었다.

일부(一部) 농촌노인(農村老人)이 지각한 가족지지(家族支持)가 우울에 미치는 영향(影響) (The Influence of Family Support Degree on the Depression of the Elderly in a Rural Area)

  • 김미숙;김기순;박종;조용래;김양옥
    • 농촌의학ㆍ지역보건
    • /
    • 제24권1호
    • /
    • pp.115-129
    • /
    • 1999
  • 일부 농촌 지역 노인을 대상으로 가족지지가 우울에 미치는 영향을 파악하기 위해 전라남도 1개 면에 거주하는 65세 이상 노인인 구 163명을 대상으로 1998년 1월 1일부터 2월 20일까지 직접 면접을 통한 설문조사를 실시하여 분석한 결과는 다음과 같다. 1. 단순분석에서 우울 정도와 관련이 있는 변수는 남자에서 주거상태, 용돈정도, 건강인식, 음주, 흡연, 신체적 수단적 활동장애 유무, 가족지지도 수준 등 이였으며 여자에서는 연령, 용돈정도, 건강인식, 흡연, 신체적 수단적 활동장애 유무, 가족지지도 수준 등이었다(p<0.05). 2. 가족지지도가 증상 영역별 우울 정도에 미치는 영향을 파악하기 위해 가족지지 정도 이외의 우울 정도와 관련되는 제 변수를 통제한 상태에서 다중 회기분석을 실시한 결과 남자의 정동증상, 신체증상, 정신운동증상, 심리적 증상 모두 통계적으로 유의하게 영향을 미쳤으며 여자에서는 신체증상, 정신운동증상, 심리적 증상에서 통계적요로 유의하게 영향을 미쳤다(p<0.05). 이상의 결과에서 농촌 노인에 있어서 가족 지지가 우울에 영향을 미치는 중요한 요인으로 작용함을 알 수 있었다. 따라서 농촌지역 노인의 우울 문제를 접근함에 있어서 가족간의 관계를 친밀하게 유지시킬 수 있는 방안을 고려하여야 할 것으로 생각한다.

  • PDF

재가 만성 뇌졸중 편마비 환자의 가정 재활운동 프로그램의 효과 (The Effect of Home Rehabilitation Exercise Program of Home Stayed Chronic Hemiplegic Stroke Patients)

  • 노국희
    • 한국보건간호학회지
    • /
    • 제16권1호
    • /
    • pp.77-94
    • /
    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

  • PDF

노인의 신체적 건강과 우울과의 관계 (The Correlation between Depression and Physical Health in the Elderly)

  • 김효정
    • 농촌의학ㆍ지역보건
    • /
    • 제26권2호
    • /
    • pp.193-203
    • /
    • 2001
  • 본 연구는 노인의 신체적 건강과 우울과의 관계를 파악하기 위한 조사연구이다. 본 연구의 대상자는 대구시에 거주하는 가정노인으로 노인 대상자 중 55세 이상인 자, 노화에 의한 시청각 장애가 심하지 않은 자, 언어적, 비언어적 의사소통이 가능한 자, 연구에 참여하기로 허락한 자로 168명이 선정되었다. 본 연구의 자료수집기간은 2000년 9월 16일부터 10월 16일까지였으며 설문지의 목적을 이해하고 면접방법에 대해 훈련받은 간호학과 학생들이 노인이 있는 가정을 방문하여 대상자를 일대일로 면접하였다. 면접자가 직접 기록하여 회수율이 100%였으며 설문지 작성에 소요되는 시간은 30-40분정도였다. 연구도구는 일반적 특성, 단축형 노인 우울척도(Short form Geriatric Depression Scale)(Sheikh와 Yesavage, 1986), Barthel의 Index(Mahoney와 Barthel, 1965)를 수정한 식사능력, 목욕능력, 세면능력, 화장실 사용능력 등으로 구성된 일상활동 능력 측정도구, 근골격계 증상(통증) 측정도구, Northern Illinois University에서 개발한 Health Self Rating Scale를 수정한 도구로 구성되었다. 자료의 분석은 SPSS WIN 10.0 통계 프로그램을 이용하였으며 연구목적에 따라 서술통계방법 (실수, 백분율), t-test, ANOVA, Pear son Correlation Coefficient, stepwise multiple regression을 이용하였다. 연구결과를 요약하면 다음과 같다. 1. 일반적 특성 중 연령(F=3.17, p=0.026), 배우자 유무(t=-2.44, p=0.016)에 따라 대상자의 우울이 통계적으로 매우 유의한 차이가 있었다. 집단간 차이를 보기 위해 사후검증한 결과 75-84세군이 65-74세군보다 우울 정도가 유의하게 높았으며 무배우자인 대상자의 우울 점수가 유배우자 보다 높았다. 2. 신체적 건강에 따른 우울 정도를 분석한 결과 일상활동능력(ADL)은 6-9점(세가지 이상의존)인 경우가 10- 12점(한 두가지 의존 또는 완전독립)인 경우보다 우울 정도가 유의하게 높았다(t=3.93, p=0.000). 근골격계 증상은 11- 13점(세 가지 이상 증상 있음), 14점 (모든 증상 있음)인 경우가 7점(전혀 증상없음)인 경우보다 우울 정도가 유의하게 높았다(F=5.33, p=0.002). 지각된 건강상태는 건강상태가 나쁘다고 응답한 대상자일수록 우울 정도가 높았다(F=17.04, p=0.000). 3. 일상활동능력이 적을수록(r=-0.293, p=0.000), 근골격계 증상이 많을수록(r=.251, p=0.001), 지각된 건강상태가 나쁠수록(r=-0.522, p=0.000) 대상자의 우울 정도가 높게 나타났다. 4. 신체적 건강 요인들의 우울에 대한 설명력은 29.1%이었으며, 이 중 지각된 건강상태의 표준 회귀계수(Beta)가 -0.456으로 가장 좋은 설명력을 가졌으며 일상활동능력(Beta=-0.140)의 순으로 좋은 설명력을 가졌다. 이상의 연구결과를 토대로 다음을 제안하고자 한다. 1. 우울 정도가 높은 가정노인을 간호하기 위해 가정노인의 우울에 영향을 주는 일상활동능력, 근골격계 증상, 지각된 건강상태 및 인구학적 특성(연령, 배우자 유무)을 고려한 건강프로그램의 개발이 필요하다. 2. 추후 연구에서는 가정노인의 신체적 건강을 측정하기 위해 다양한 도구를 사용할 것을 제안한다.

  • PDF

만성통증 환자의 통증 조절 (Chronic pain control in patients with rheumatoid arthritis)

  • 은영
    • 근관절건강학회지
    • /
    • 제2권1호
    • /
    • pp.17-40
    • /
    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

  • PDF

지역사회 거주 경도인지장애 노인의 유병율과 정상 노인과의 비교연구 (Prevalence and Characteristics of Mild Cognitive Impairment in the Community-dwelling Elderly Compared to Elderly with Normal Cognitive Function)

  • 신경림;강윤희;정덕유;김미영;김정수;김미정;김민정
    • 성인간호학회지
    • /
    • 제23권1호
    • /
    • pp.40-49
    • /
    • 2011
  • Purpose: This study aimed to identify the prevalence of mild cognitive impairment (MCI) among a group of community-dwelling elderly and to determine if there were differences in general characteristics, activities of daily living (ADL), perceived health status (PHS) between the MCI group and group of elderly with normal cognitive function. Methods: This study utilized a descriptive survey design. Six hundred and five subjects over the age 65 were recruited from an S public health center, Seoul. Data were gathered through a variety of instruments: MoCA-K, K-MMSE, K-MBI, S-IADL, and PHS scale. Data were analyzed by SPSS/WIN 18.0 using descriptive statistics, Chi-Square test and t-test. Results: The prevalence of MCI among the subjects was 46.0%. Differences in IADL, PHS, age, education, sex, and residing with a spouse were statistically significant between groups. The MCI group had lower IADL, lower PHS, were older, and had lower educational levels than the group with normal cognitive function. Further, the MCI group was less likely to live with a spouse. Conclusion: It is suggested that MCI group should be targeted in developing and implementing nursing strategies to prevent dementia and improve the elderly cognitive function.

치매의 침치료에 대한 해외 RCT 연구 동향 - pubmed의 2000~2018년 검색을 통하여 - (Recent RCT Research on the Effects of Acupuncture on Dementia - Based on a PubMed Search of Literature Published from 2000 to 2018)

  • 김은지;최기훈;정희경;권오훈;박주헌;김상균
    • 대한한방내과학회지
    • /
    • 제39권3호
    • /
    • pp.338-349
    • /
    • 2018
  • Objective: The purpose of this study is to investigate recent clinical studies on the effects of acupuncture on dementia. Method: We searched RCTs (randomized controlled trials) using the database PubMed (2000-2018). Clinical RCT studies of acupuncture used to treat dementia in humans were included. Nine randomized controlled trials were included. Results: Various acupoints such as Baihui (GV20), Sishencong (EX-HN1), Fengchi (GB20), and Shenting (GV24) were used to treat symptoms. The studies reported a decrease in evaluation criteria, such as the Mini Mental State Examination (MMSE) and activities of daily living (ADL), for measuring cognitive ability. The acupuncture process, the results for outcome measure, and the effectiveness of studies were analyzed. We then assessed "risk of bias." Conclusions: Through this review, we found that acupuncture is applicable for the treatment of dementia. This can be used for future study.

일부 지역사회 노인들의 의료서비스 접근성에 관한 조사 연구 (Accessibility of Medical Care in an Elderly Population)

  • 조경순;이현주
    • 성인간호학회지
    • /
    • 제12권4호
    • /
    • pp.641-653
    • /
    • 2000
  • A quantitative descriptive survey was conducted to assess the needs of elderly people in relation to accessibility of medical care. Identifying their functional status was done and accessibility of medical care was ascertained. Using a convenient sampling method, 856 elderly aged 65 and over in Taejon-city participated. A multi-dimensional questionnaire containing sections on health status, Activities of Daily Living(ADLs) and accessibility of medical care in terms of use, time, distance, transport, cost and feeling at ease was developed by the researchers of this study to collect data. Data were collected between October and December, 1999. In general, the result of the self-reports from this study found that approximately 40% of participants had difficulties with their health status and ADLs while about 45% of the population did not access medical care. The majority of respondents stated that they had no difficulties with time distance and transport to access medical care. About two-thirds of the respondents felt that they had many or some difficulties with expenses and strategies for emergency to access medical care. Even though these findings need to be generalized, several recommendations for appropriate medical care delivery for the elderly still can be outlined from the study findings. Recommendations suggested are: To identify impediments to access medical care in emergency in elderly people and to remove those factors preventively are required. Responsible governmental involvement for solving problems of the medical care cost and additional costs in relation to separation of dispensary from medical practice for the elderly is required. More constructive and practical uses of public health community centers are recommended.

  • PDF