• 제목/요약/키워드: Chronic Stroke

검색결과 626건 처리시간 0.024초

장애인의 국민건강보험 건강검진 수검에 영향을 미치는 요인 (Factors Affecting National Health Insurance Mass Screening Participation in the Disabled)

  • 박종혁;이진석;이진용;홍지영;김소영;김성옥;조병희;김용익;신영수;김윤
    • Journal of Preventive Medicine and Public Health
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    • 제39권6호
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    • pp.511-519
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    • 2006
  • Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

Effect of Preexisting Musculoskeletal Diseases on the 1-Year Incidence of Fall-related Injuries

  • Lee, Won-Kyung;Kong, Kyoung-Ae;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • 제45권5호
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    • pp.283-290
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    • 2012
  • Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

Effects of Slope Changes During Body Weight-Supported Treadmill Training on Gait Characteristics in Patients With Hemiplegia

  • Hwang, Young-In;An, Duk-Hyun
    • 한국전문물리치료학회지
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    • 제15권4호
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    • pp.10-17
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    • 2008
  • The purpose of this study was to determine the therapeutic effect of slope changes of the treadmill with body weight-supported training on gait characteristics in patients with hemiplegia. The volunteered subjects were divided into 3 groups based upon slope changes: control group ($0^{\circ}$ incline), $7^{\circ}$ group ($7^{\circ}$ incline), $12^{\circ}$ group ($12^{\circ}$ incline), They were trained the body weight-supported treadmill training (BWSTT) for 8 weeks. All subjects were supported up to 40% of their body weight on the treadmill training and the support was gradually decreased to 0~10% as the subjects were adapted to the training. There were significant improvements of walking velocity, step length of the affected side, the asymmetry ratio of step length in $7^{\circ}$ group (57.80 cm/s, 67.25 cm, .14), $12^{\circ}$ group (71.00 cm/s, 71.00 cm, .11) than control group (40.62 cm/s, 55.00 cm, .74) (p<.05): there were no differences between $7^{\circ}$ group and $12^{\circ}$ group in the all outcomes (p>.05). Both $7^{\circ}$ group and $12^{\circ}$ group scored higher than the control group in those outcomes and finally the effects of slopes changes of the treadmill were effective on gait characteristics of patients. But it s till remains undetermined what degree on the treadmill might be better to train the hemipareric patients. Therefore, more studies are required to look into minutely the changes of slopes of the treadmill influencing on gait characteristics.

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중의학 변증과 양방 검사의 상관관계 연구 현황 -CNKI를 이용하여- (A Review Study in the Correlation between Pattern Identification of Traditional Chinese Medicine and Western Medicine Examination -Research on CNKI-)

  • 윤영주;조영주;이지혜;임정화;성우용
    • 동의신경정신과학회지
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    • 제24권1호
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    • pp.13-26
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    • 2013
  • Objectives : The purpose of this study is to investigate the correlation between pattern identification of traditional Chinese medicine (TCM) and western medicine, examined by a systematic research of Chinese medicine papers. Methods : We searched for the papers regarding pattern identification of TCM published from 1994 to 2012 in CNKI (China National Knowledge Infrastructure http://www.cnki.net) at April, 2012. Results : A total of 30 studies were finally included; 18 studies of them were related to stroke (cerebral infarction) and there were 12 studies regarding other diseases, such as hypertension, chronic colonitis, vascular dementia, mild cognitive impairment and etc. All 30 studies were analyzed and classified by diseases, differentiation of syndromes, numbers of subjects, the instrument of pattern identification, items of western medicine examination and statistical results. Conclusions : According to our study, there are some correlations between pattern identification of TCM and various items of western medicine examination. The result suggests a possibility of using the western medicine examination data for pattern identification of TCM.

학술논문 분석을 통한 기상민감질환 선정 및 기상인자와의 관련성고찰 (Weather-sensitive Diseases and Their Correlations with Meteorological Factors: Results from Academic Papers)

  • 안혜연;정주희;김태희;윤진아;김현수;오인보;이지호;원경미;이영미;김유근
    • 한국환경과학회지
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    • 제25권6호
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    • pp.839-851
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    • 2016
  • The effect of weather on disease was investigated based on results reported in academic papers. Weather-sensitive disease was selected by analyzing the frequency distributions of diseases and correlations between diseases and meteorological factors (e.g., temperature, humidity, pressure, and wind speed). Correlations between disease and meteorological factors were most frequently reported for myocardial infarction (MI) (28%) followed by chronic ischemic heart disease (CHR) (12%), stroke (STR) (10%), and angina pectoris (ANG) (5%). These four diseases had significant correlations with temperature (meaningful correlation for MI and negative correlations for CHR, STR, and ANG). Selecting MI, as a representative weather-sensitive disease, and summarizing the quantitative correlations with meteorological factors revealed that, daily hospital admissions for MI increased approximately 1.7%-2.2% with each $1^{\circ}C$ decrease in physiologically equivalent temperature. On the days when MI occurred in three or more patients larger daily temperature ranges ($2.3^{\circ}C$ increase) were reported compared with the days when MI occurred in fewer than three patients. In addition, variations in pressure (10 mbar, 1016 mbar standard) and relative humidity (10%) contributed to an 11%-12% increase in deaths from MI and an approximately 10% increase in the incidence of MI, respectively.

신경신호 기록을 위한 PZT기반 마이크로 드라이브 (Miniature PZT actuated microdrive for chronic neural recording in small animals)

  • 박상규;박현준;박석호;김병규;신희섭;이석찬;김희수;김은태
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2005년도 학술대회 논문집 정보 및 제어부문
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    • pp.38-40
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    • 2005
  • Microdrive with high precision and light mass enough to install on mouse head was fabricated for recording the reliable signal of neuron cell to understand the brain study. The proposed microdrive has three H-form PZT actuators and its guide structure. The microdrive operation principle is based on the well known inchworm principle. The synchronization of three PZT actuators is able to produce the linear motion along the guide structure. Our proposed microdrive has a precise accuracy of about 100nm and a long stroke of about 5mm. The electrode which is used for the recording of the action potential of the neuron cell was fixed at one of PZT actuators. The proposed microdrive was suited to acquisition of signals from in vivo extra-cellular single-unit recoding. On the condition of the anesthetized mouse, the single-unit signals could be recorded by using the proposed microdrive. In addition, applying the PZT microdrive to an alert mouse, we try to implant it on a mouse brain skull to explore single neuron firing.

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노인복지시설의 급식관리 및 영양 건강 증진에 관한 연구 - 급식과 건강관리 - (Management of Food Service and Health Care in Long-Term Care in Korea - Food Service and Health Care -)

  • 김화영;양은주;원혜숙
    • 한국식생활문화학회지
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    • 제12권3호
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    • pp.331-339
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    • 1997
  • With increases in senior citizens and changes in family structure, the need for long-term care system for elderly is increasing, however, the capacity and environment of Korean facilities are very limited. Health and nutritional status of long-term care residents are worse than free-living elderly. In this study, general food service management and health care practices in long-term care systems were investigated. Questionnaire were sent to the directors of all 162 long-term care facilities in Korea and 81 returned the complete answers. The results showed 1) There are slow but steady increase in long-term care systems in Korea, however, the capacity is far from adequate. Less than 10,000 elderly were resided in the facilities. Most of the systems were free-nursing homes and supported by the goverment. Staffing structure revealed that most of the facilities had a director, a secretary, nurses, but only 21% of the systerm hired a dietitian. It showed the shortage of nurses, physical therapists, and dietitians. Therefore, food purchasing, menu planning, food delivery, and the other food service management processes are handled by non-professionals, such as director, secretary, or cooks. Modified fool frequency questionnaire were used to get the frequencies of each food items used in menu and a menu-analysis was made on the one-day menu provided by the facilities. The results showed relatively satisfactory in nutrients content and food frequencies., however, this was about what was used in menu, not what was eaten by the residents. Therefore this results did not tell that the food intake status of individuals. In most facilities general health checkup was done on a regular basis, and had residents with various chronic degenerative diseases, such as hypertension, neuralgia, stroke, arthritis, diabetes. But the items checked on health checkup included weight, height, blood and urine tests, X-ray test, which suggested that the checkup lists should be revised to accomodate the health problem of the aged today.

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흡기근 저항훈련이 만성 뇌졸중 환자의 횡격막 두께와 폐기능에 미치는 효과 (Effects of Inspiratory Muscle Training on Diaphragm Thickness, Pulmonary Function, and Chest Expansion in Chronic Stroke Patients)

  • 정주현;김난수
    • 대한물리의학회지
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    • 제8권1호
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    • pp.59-69
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    • 2013
  • 연구목적: 본 연구는 만성 뇌졸중 환자를 대상으로 흡기근 저항훈련이 횡격막 두께와 폐기능 및 흉곽 확장에 미치는 효과를 알아보고자 수행하였다. 연구방법: 연구 대상자는 총 29명(남자 17명, 여자 12명)으로 흡기근 저항훈련군(15명)과 대조군(14명)으로 분류하였다. 모든 대상자는 6개월 이상된 만성 뇌졸중 환자로 일반적인 신경발달치료를 받고 있으며, 같은 기간 동안 흡기근 저항훈련군에 역치부하 흡기근육 단련기(threshold IMT device)를 제공하고 주 3회${\times}$1회 20분씩 6주간 시행하였다. 마비측과 비마비측 횡격막 두께측정을 위해 초음파의 7.5MHz linear probe를 사용하여 최대 흡기시(Tdi.con)와 휴식시(Tdi.rel)의 두께를 측정하고 수축률(TR)을 계산하였다. 또한 폐 활량계를 사용하여 노력성 폐활량을 측정하였으며, 줄자를 사용하여 흉곽 확장을 측정하였다. 연구결과: 6주간 중재 후 흡기근 저항훈련군에서 최대흡기시 횡격막 두께(Tdi.con)와 수축률(TR)은 유의한 증가를 보였다(p<.05). 1초간 노력성 호기량 ($FEV_1$)과 최대 호기 속도(PEF)도 유의한 증가를 보였으나(p<.05), 노력성 폐활량(FVC)과 1초간 노력성 호기량의 노력성 폐활량에 대한 비($FEV_1$/FVC), 흉곽 확장은 유의한 증가는 보이지 않았다(p>.05). 결론: 본 연구는 만성뇌졸중 환자를 대상으로 흡기근 저항훈련의 적용이 횡격막의 수축력과 폐기능 및 흉곽 확장력을 향상시켜 호흡근의 협응력을 증가시키고, 비활동성으로 인해 감소된 운동내성을 증가하게 함으로써 향후 재활에서 만성 뇌졸중 환자에게 2차적인 기능향상에 도움을 줄수 있을 것으로 보여진다.

도시지역 취약가구의 방문간호서비스 평가 (Evaluation of Visiting Nursing Services for the Vulnerable Family in Urban Community)

  • 박경민
    • 지역사회간호학회지
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    • 제15권1호
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    • pp.56-66
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    • 2004
  • Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

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Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

  • Jongudomkarn, D;Singhawara, P;Macduff, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4401-4408
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    • 2015
  • Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.