• Title/Summary/Keyword: Home-based rehabilitation

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A hybrid cardiac rehabilitation is as effective as a hospital-based program in reducing chest pain intensity and discomfort

  • Saeidi, Mozhgan;Soroush, Ali;Komasi, Saeid;Singh, Puneetpal
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.265-271
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    • 2017
  • Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. Results: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). Conclusions: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.

A Study on the Effect that Rehabilitation Education Influence on the Knowledge Attitude and Practice of Public Health Nurse (재활교육이 보건간호사의 재활에 대한 지식, 태도, 실천에 미치는 효과 연구)

  • Jo, Kye-Suk;You, In-Ja;Bae, Jung-Hee;Lee, Young-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.63-73
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    • 1998
  • The home visiting health nurses are important man-power who can serve various and persistent rehabilitation care to disabled person in community. The Community Based Rehabilition project(CBR) of national rehabilition center have been carried out from 1995. As a part of that project national health center performed rehabilition education program for home visiting health nurses. The purpose of this study is to analysis the effect of this education. In the first stage all of those groups were educated for two weeks in national rehabilitation center. But only two group nurses, one is in a urban and the other in a rural community, have been educated continually in the field through discussing rehabilitation care case study. The data in this study were gathered from three group healh nurses and analysed by SAS computer program. The results about knowledge, attitude and practice changes of the three group nurses were as follows. 1. In the pre education state the mean point of all nurses' attitude for rehabilition was 59, but in the post education state that was 90. The difference between pre and post attitude is very significant(t=-14.1. p<0.0001l). 2. In the pre education state the mean point of all nurses' knowledge for rehabilition was 45, but in the post education state that was 78. The difference between pre and post knowledge is very significant(t=-12.7, p<0.000l). 3. In the pre education state the mean point of all nurses' practice for rehabilition care was 37, but in the post education state that was 62. The difference between pre and post practice is very significant(t=-7.3, p<0.000l). 4. In practice point, the two group nurses who have been educated continuously were superior to the other(t=-3.9. p<0.00l). 5. All points between the urban and rural nurses were no significant differences(p>0.l). 6. All changes of the attitude, knowledge and practice did not affected by age(F=0.58, p>0.l). professional career(F=O.61, p>0.l), educational background(F=0.97, p>0.l).

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Case Analysis of Visiting Nursing Center for Improving Efficiencies: Based on Business Management Consulting (방문간호센터 경영효율성 개선 사례 분석: 경영 컨설팅 적용을 중심으로)

  • Lim, Ji Young;Kim, Juhang;Kim, Seonhee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.28 no.2
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    • pp.111-123
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    • 2021
  • Purpose: This study aimed to present the management strategies necessary to improve the operational efficiency of visiting nurse centers and evaluate their effectiveness. Methods: The subjects of this study were visiting nurse centers registered as long-term care centers. Based on value chain analysis, cost information analysis, and data envelope analysis, the study was carried out according to the Magerison's management consulting procedure, for six months. This procedure comprised eight sub-steps of approach and application. Results: The following management strategies were agreed upon: establishment of a cooperative network with other visiting care centers, creation of high satisfaction of external customers by providing practical training to care workers, and making rehabilitation and exercise services as the core nursing activities to be focused on. Conclusion: The management consulting process and analysis method applied in this study can referred to as a useful methodological framework for revitalizing visiting nursing centers in the future.

Application of Cognitive Enhancement Protocol Based on Information & Communication Technology Program to Improve Cognitive Level of Older Adults Residents in Small-Sized City Community: A Pilot Study (중소도시 지역사회 거주 노인의 치매예방을 위한 Information & Communication Technology 프로그램 기반 인지향상 프로토콜 적용: 파일럿(Pilot) 연구)

  • Yun, Sohyeon;Lee, Hamin;Kim, Mi Kyeong;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.69-83
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    • 2023
  • Objective : This study, as a preliminary study, applied an Information & Communication Technology (ICT) home-based program to elderly people aged 65 years or older to confirm the effect of the cognitive enhancement program and to find the possibility of remote rehabilitation. Methods : This study from August to October 2022, three subjects were selected and the intervention was conducted for about 2 months. This intervention was conducted using Korean version of Mini-Mental State Examination, Korean version of Montreal Cognitive Assessment (MoCA-K), Computer Cognitive Senior Assessment System, and the Center for Epidemiologic Studies Depression scale to evaluate cognitive improvement before and after the program. The therapist remotely set the level of cognitive training according to the subject's level through weekly feedback. Results : After the intervention, all subjects showed improved scores in most items of the MoCA-K conducted before and after the intervention. In addition, among the items of Cotras-pro, upper cognition, language ability, attention, visual perception, and memory were improved. Conclusion : Cognitive rehabilitation training using an ICT home-based program not only prevented dementia but also made it habitual. Through this study, it was confirmed that remote rehabilitation for the elderly could be possible.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Analysis of Factors Influencing on the Early Treatment of Children With Developmental Disability (발달장애아의 조기치료에 영향을 미치는 요인 분석)

  • Park, Hye-Jeong;Kim, Sun-Hye
    • Physical Therapy Korea
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    • v.6 no.1
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    • pp.47-61
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    • 1999
  • The purpose of this study was to investigate factors influencing on the early treatment of children with developmental disability. Data was collected from 102 mothers of children with developmental disability who were treated at 4 rehabilitation facilities in Kyunggi-Do and Kangwon-Do. The results were as follows: 1) Of a total of 102, 63 children began to receive rehabilitation therapy during the period 0~12 months (early treatment group), 38 children after 1 year of age (delayed early treatment group). 2) There were statistically significant differences between the early treatment group and delayed early treatment group for prematurity, low birth weight, the time to discover developmental abnormalities, the time of first diagnosis, and first treatment (p<0.05). 3) There were no statistically significant differences in the two groups for level of education, economic status, risk factors (except prematurity and birth weight), home care, family's cooperation and commuting time (p>0.05). Based on this study, the important factors for early treatment were early detection, early diagnosis and constant follow-up for high-risk babies.

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A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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Impacts of Repeated Victimization from Domestic Violence on Depression, and Moderating Effects of Social Support Networks : Focusing on Wives Whose Husbands Participated in the Correction and Rehabilitation Program for Family Violence Perpetrators (아내폭력 재피해 경험이 여성의 우울에 미치는 영향과 사회적 지지관계망의 조절효과 - 가정폭력 행위자 교정.치료프로그램 참여 남성의 아내를 중심으로 -)

  • Kim, Jae-Yop;Chung, Yun-Kyung;Lee, Keun-Young
    • Journal of the Korean Home Economics Association
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    • v.46 no.8
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    • pp.85-95
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    • 2008
  • This study examined the revictimization of wives from repeated husband violence and how that affected their depression. It also explored whether social support networks can have moderating effects. Sixty-four wives participated in the research group, 72.3% of whom had experienced repeated verbal violence, and 29.2% experienced repeated physical violence since their husbands participated in the correction and rehabilitation program for family violence perpetrators. Revictimization from repeated husband-to-wife violence was proven to significantly influence wife depression. To moderate the harmful effects of repeated domestic violence on depression, social support networks were observed to provide protective reinforcements. However, the findings of this study did not support the notion that social support networks have moderating effects on wife depression, while a strong negative relationship was established between professional networks of social support networks. Based on these results, the research discussion here advocates for an intervention that promotes psychological health to wives who are exposed to repeated domestic violence.

A Development Study on New Hand Rehabilitation Training Tool Using Cat's Cradle Game (실뜨기 놀이를 활용한 새로운 수부재활훈련도구 개발 연구)

  • Lee, Yu Sol;Chung, Do Sung
    • Design Convergence Study
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    • v.17 no.3
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    • pp.1-19
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    • 2018
  • Hand rehabilitation training tools are used in hospitals and at home for patients and users who require recovery of disabled hands and improvement in overall hand function. However, existing training tools are not organized into a progressive system, and they lead to repeatability operations over a period of time. As a result, patients feel free and cannot be motivated by rehabilitation, and continuous rehabilitation training is difficult. Based on this argument, the study combines one of the elements of the game called the "Cat's cradle" to enable the user to feel achievement through play and to achieve natural rehabilitation through unconsciousness. After examining the characteristics of the tool, the user's environment, the relevance of the Cat's cradle game to the training tool and to the patient's continued rehabilitation was established. And design elements were derived through professional interviews. Later, design guidelines and prototypes have been created to complement the problems associated with guidelines and prototypes by conducting usability testing and design element assessment.

The Development and Effects of an Upper Extremity Exercise Program Based on Patterned Sensory Enhancement for Home-bound Stroke Patients (재가 뇌졸중 환자를 위한 패턴화된 감각향상(PSE) 상지운동 프로그램의 개발 및 효과)

  • Hong, Myung-Sun
    • Research in Community and Public Health Nursing
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    • v.22 no.2
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    • pp.192-203
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    • 2011
  • Purpose: This study was conducted to develop and assess the feasibility of an upper extremity exercise program based on Patterned Sensory Enhancement (PSE) for home-bound stroke patients by measuring the level of upper extremity function, depression, and interpersonal relationship. Methods: The experiments were performed on stroke patients at three different rehabilitation centers in Incheon City. Twenty patients participated in the experimental group or in the control group. The program was executed three times a week for 6 weeks. Data were collected from August to October, 2006. Manual Function Test was used to quantify and evaluate upper extremity function. The depression level and the effectiveness of interpersonal relationship were quantified and measured using CES-D and Relationship Change Scale, respectively. Results: The effectiveness of upper extremity function of stroke patients who participated in the PSE upper extremity exercise program was higher than that of non-participating patients. The depression level decreased and interpersonal relationship improved in the stroke patients who participated in this program compared to those who did not. Conclusion: These findings prove that the PSE upper extremity exercise program for home-bound stroke patients was an effective strategy for enhancing upper extremity function, decreasing the depression level, and improving interpersonal relationships.