• Journal of Hospice and Palliative Care
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• 제12권4호
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• pp.177-193
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• 2009

완화의학에서 환자의 평가는 치료의 의사결정과 그 결과에 이르기까지 중요한 역할을 한다. 평가도구의 사용 목적은 이를 환자 진료에 반영하여 개개인 환자와 가족들에 대한 돌봄의 질을 높이는 데 있다. 환자의 기능 상태와 통증 및 비 통증 증상을 평가하는 다양한 단일 영역 및 다차원 평가 척도들이 사용 가능하며, 삶의 질을 측정하는 다양한 도구들이 존재한다. 삶의 질이나 증상 측정에서 우월하다고 추천되는 단일 도구는 없는 실정이다. 도구마다 측정하는 시간의 틀이 다르고, 특성이 다르므로 사용 목적과 상황에 따라 적절한 도구를 선택하여야 한다. 여명 예측을 위해서는 예후 지수의 병용이 권고되는 추세이고, 웹을 기반으로 하는 예측 프로그램들도 등장하였다. 예후지수로는 최근 우리나라에서 다기관 연구를 통해 개발한 객관적 예후지수가 임상적인 여명 예측을 포함하지 않으면서 새로운 객관적인 예후 요인을 반영하여, 누구나 쉽게 사용이 가능하다. 완화의학 입문자의 경우 상대적으로 사용이 용이한 도구가 좋다. 따라서 기능의 평가에는 Eastern Cooperative Oncology Group 기능지수를 사용하고, 통증에서는 10점만점의 숫자 통증 등급(Numeric Rating Scale) 도구를 활용하면서 초기 통증 평가로는 간이 통증 조사지를 추천한다. 여러 가지 증상을 한꺼번에 측정하기 위해서는 숫자 등급으로 직접 물어보거나 혹은 M.D. Anderson 증상조사지(the Korean version of MD Anderson Symptom Inventory) 설문지를 사용하기 바란다. 삶의 질을 평가하는데에는 European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care, 예후 지수로는 객관적 예후 지수(Objective Prognostic Score)를 사용하기를 권한다. 향후 완화의학에서 평가도구의 발전방향은 국제 공동 연구의 활성화와 디지털 기기를 통한환자 보고의 전산화이고, 머지않은 앞날에 우리나라에도 이러한 경향이 도입될 것이다.

• Journal of Preventive Medicine and Public Health
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• 제34권2호
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• pp.175-181
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• 2001

Objectives : To compare the multiple outcomes of patients with cataract surgery at perioperative time,3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). Methods : For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was peformed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was 'conducted at 4 stages' : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. Results : The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 mouths. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom sure were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(09.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. Conclusions : In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.

• 한국의료질향상학회지
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• 제5권1호
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• pp.128-138
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• 1998

Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.216-223
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• 2018

Objectives: The purpose of the study was to investigate factors affecting the assessment of objective and subjective masticatory ability in the elderly, and to evaluate masticatory ability assessment more accurately. Methods: A total of 112 participants were recruited after oral examination in senior citizen welfare facilities. The participants' masticatory ability was evaluated objectively (Mixing ability index; MAI), and subjectively (Key food intake ability; KFIA). Participants' general characteristics and oral health-related variables were also recorded. Based on masticatory ability assessment, participants were classified as either high or low. IBM SPSS Statistics Ver.23.0 was used for all analyses, including descriptive statistics, Chi-square test, Mann-Whitney U test, Spearman rank correlation, and Logistic regression analysis. Results: Higher masticatory ability was positively correlated with higher scores on MAI and KFIA. Additionally, there was a significant positive correlation between MAI and KFIA. When analyzing factors affecting objective and subjective masticatory ability assessments, Functional tooth units (FTUs) were revealed as a related factor. In subjective masticatory ability assessment, oral moisture, difficulty in chewing, and the Geriatric Oral Health Assessment Index (GOHAI) were also influential factors. Conclusions: In order to accurately assess masticatory ability, it is necessary to use both objective and subjective measures. Additionally, to improve the masticatory ability in the elderly, treatment should be provided to improve overall oral health and satisfaction.

• 융합신호처리학회논문지
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• 제14권3호
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• pp.147-153
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• 2013

기능성 게임은 놀이와 학습의 결합 형태이며 미래 지향적 도구로, 기존의 게임이 가지고 있는 역기능을 최소화하고 순기능을 최대화할 수 있으며 게임 산업 및 게임 문화를 바꿀 수 있는 새로운 대안으로 자리매김하고 있다. 최근의 게임 및 교육시장은 사용자의 자율성과 동기를 강조하는 보다 진보된 형태의 학습 콘텐츠 개발로 이동하고 있다. 이와 맞물려 게임 시장 또한 게임 중독 및 학업 부진과 같은 사회 역기능적인 요소를 배제하며, 정신과 육체의 건강을 중시하고 과학적인 교육 효과를 추구하는 인간 친화적 형태의 엔터테인먼트 사업으로의 확장을 다각화하고 있다. 또한, 기능성 게임은 의료보조 및 의료학습, 군사 시뮬레이션, 건강. 보조도구, 특수교육 및 학습 도구같은 전문적인 영역에서 일상적인 교육 및 정신 건강 등으로 확대되고 있으며, 시장도 꾸준히 성장하고 있는 추세이다. 그러나 이러한 시장 특수성에 부응하여 현재 기획 및 개발되고 있는 기능성 게임의 대부분은 그 기능에 대한 정확한 과학적 측정과 효과 검증이 이루어지지 못하고 있으며, 대부분 게임 개발자의 직관과 경험에 의존하여 개발되고 있다. 또한, 전반적으로 단순한 과제를 반복하거나 간단한 퍼즐 형태의 게임으로 실제적 재미 요소와 학습의 효과를 효과적으로 결합시키지 못하고 있으며, 인간기능의 측정보다는 막연한 기능 증진을 기대하는 비과학적인 방법의 게임이 대부분이다. 이에 본 논문에서는 시각 및 청각 자극 변화에 따른 기능성 게임의 몰입도 및 집중도 변화를 분석하여 기능성 게임의 효과적인 시청각 자극 제시 방안과 관련한 연구를 수행하였다. 이를 위하여 본 논문에서는 2D 형태의 기능성 게임(가청 주파수 대역의 게임 음향), 3D 형태의 기능성 게임(가청 주파수 대역의 게임 음향), 3D 형태의 기능성 게임(가청 주파수 대역의 게임 음향 및 초음파 영역 게임 보조 음향)을 활용한 3단계의 시각 및 청각 자극 변화 실험 수행하며 사용자의 뇌파를 측정 및 분석한 결과를 제시한다.

• 대한한방내과학회지
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• 제43권2호
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• pp.229-236
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• 2022

Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.

• Physical Therapy Rehabilitation Science
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• 제13권1호
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• pp.43-52
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• 2024

Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.

• 대한간호학회지
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• 제31권3호
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• pp.454-466
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• 2001

Purpose: The purpose of this study was to determine the effects of exercise program on cardiopulmonary functions and shoulder joint functioning in breast cancer patients who under- went radiation therapy after surgery. Method: Subjects in the experimental group(N=12) participated in an exercise program for eight weeks. The Exercise program consisted of shoulder stretching, arm weight training, and walking on treadmill. Maximal oxygen uptake (v2max), maximal running time, shoulder joint range of motion, and shoulder functional assessment were determined before and after the exercise program. Baseline sociodemographic and medical data were compared between experimental group and control group using the Fisher's exact test and Mann- Whitney U test. For effects of the exercise program, repeated measures ANOVA were used. Result: 1) Following the exercise program for eight weeks, both v$\alpha$ max and maximal running time tended to increase in experimental group comparing with the control group. 2) Shoulder abduction, extension and flexion of the operated upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). 3) Shoulder flexion of the normal upper extremity in the experimental group comparing with control significantly increased after the exercise program(p<0.05). Conclusion: The results suggest that the exercise program for breast cancer patients undergoing radiation therapy after breast surgery can improve shoulder functions and increase cardiopulmonary functions, which are maximal oxygen uptake and maximal running time.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.343-349
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• 2012

Objective : Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system. Methods : Five sites participated in a retrospective study of 72 consecutive patients who underwent NFlex stabilization. Of these 72 patients, 65 were available for 2-year follow-up. Patients were included based on the presence of degenerative disc disease (29 patients), degenerative spondylolisthesis (16 patients), lumbar stenosis (9 patients), adjacent segment degeneration (6 patients), and degenerative lumbar scoliosis (5 patients). The clinical outcome measures at each assessment were Visual Analogue Scale (VAS) to measure back pain, and Oswestry Disability Index (ODI) to measure functional status. Radiographic assessments included evidence of instrumentation failure or screw loosening. Results : Sixty-five patients (26 men and 39 women) with a mean age of 54.5 years were included. Mean follow-up was 25.6 months. The mean VAS score improved from 8.1 preoperatively to 3.8 postoperatively, representing a 53% improvement, and the ODI score from 44.5 to 21.8, representing a 51% improvement. Improvements in pain and disability scores were statistically significant. Three implant-related complications were observed. Conclusion : Posterior pedicle-based dynamic stabilization using the NFlex system seems effective in improving pain and functional scores, with sustained clinical improvement after two years. With appropriate patient selection, it may be considered an effective alternative to rigid fusion.

• 한국전문물리치료학회지
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• 제15권1호
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• pp.77-85
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• 2008

The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.