• 제목/요약/키워드: Integrative Framework

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Effects of Treadmill Exercise on Pulmonary Function and Gait Capacity in Stroke Patients : A meta-analysis (트레드밀 운동이 뇌졸중 환자의 폐기능과 보행능력에 미치는 효과 : 메타분석)

  • Cho, Sunghyoun;Choi, Kibok
    • Journal of The Korean Society of Integrative Medicine
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    • 제8권2호
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    • pp.169-185
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    • 2020
  • Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group (취약계층 임산부·어머니·영유아 대상 방문건강관리서비스에 대한 통합적 문헌고찰)

  • Kim, Dasom;Lee, Insook
    • Journal of Korean Academy of Nursing
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    • 제47권5호
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    • pp.577-588
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    • 2017
  • Purpose: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. Methods: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Results: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. Conclusion: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units (신생아중환자실에서의 가족중심돌봄 기반 가족중재연구에 대한 통합적 문헌고찰)

  • Chung, Nary;Kim, Yeseul;Park, Eunyoung;Yeo, Lisa;Hwang, Jiwon
    • Perspectives in Nursing Science
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    • 제16권1호
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    • pp.35-44
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    • 2019
  • Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.

The Effect of Instrumental Activities of Daily Living Program on General Self-Efficacy, Motivation for Rehabilitation, Social Support in a Patient with Subacute Stroke (도구적 일상생활 프로그램이 회복기 뇌졸중 환자의 자기효능감, 재활 동기, 사회적 지지에 미치는 영향)

  • Choi, Minkyung
    • Journal of The Korean Society of Integrative Medicine
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    • 제7권3호
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    • pp.11-19
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    • 2019
  • Purpose : The purpose of this study is to examine the effect of instrumental-activity of daily living program on a patient with subacute stroke in the view of self-efficiency, motivation for rehabilitation, social support. Methods : Eight stroke patients who attended instrumental-activity of daily living program at P hospital in Busan Metropolitan City from march 2018 to January 2019 were recruited. Instrumental-activity of daily living program was offered to 8 stroke patients 1 session (at least 1 hours) a day, 5 times a week, for 4~5 weeks. The instrumental-activity of daily living program was based on occupational therapy practice framework (OTPF) and international classification of functioning, disability and health (ICF). We evaluated self-efficacy, rehabilitation motivation, social support before and after intervention. Self-efficacy was evaluated using the general self-efficacy scale. The collected data was processed using SPSS 20.0 and were analyzed using descriptive statistics, Wilcoxon signed rank test, Pearson's correlation coefficient. Results : There were statistically significant differences in self-efficiency, rehabilitation motivation, social support between before and after instrumental-activity of daily living program (p<.05). Examining the correlation between the self-efficiency, rehabilitation motivation and social support of the stroke patient, there was a correlation between the self-efficiency and social support (p<.05). Conclusion : This study showed that the instrumental-activity of daily living program have positive effects on self-efficacy, rehabilitation motivation, social support. When considering the instrumental-activity of daily living program with improved self-efficacy, rehabilitation motivation, social support of the participants, we suggest that further studies will be needed to examine more extensive instrumental-activity of daily living and rehabilitation to the society with a larger sample size.

Association of Health Outcomes with Frailty in Community-Dwelling Korean Older Adults: An Integrative Review (국내 지역사회 거주 노인의 허약과 건강결과 간의 관계에 대한 통합적 고찰)

  • Son, Youn-Jung;Lee, Suk Jeong;Choi, Yu Ri
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • 제26권1호
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    • pp.5-18
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    • 2019
  • Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.

Health Condition of Residents of Mental Health Sanatoriums and Policy Options (정신요양시설 거주인의 건강 실태 및 정책 대안)

  • Jo, Han-Jin;Lee, Seung-Hong
    • Journal of The Korean Society of Integrative Medicine
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    • 제10권2호
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    • pp.49-59
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    • 2022
  • Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.

Identification of Distinct Vaginal Microbiota Signatures Contributing Toward Preterm Birth Using an Integrative Computational Approach

  • Sudeepti Kulshreshtha;Priyanka Narad;Brojen Singh;Deepak Modi;Abhishek Sengupta
    • Microbiology and Biotechnology Letters
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    • 제51권1호
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    • pp.109-123
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    • 2023
  • Preterm birth (PTB) is defined as giving birth prior to the 37th week of pregnancy and is a major cause of infant mortality. Studies have indicated that the vaginal microbiota's composition and its dysbiosis, particularly during pregnancy, may play a major role in PTB. While previous research work concentrated on well-studied microorganisms such as Lactobacillus, Prevotella, Gardnerella, various other microbes, and their significance in the vaginal microbiota's stability remain unknown. Moreover, current studies have focused primarily on the relative abundances of the microbes found, without considering their interactions with other members of the vaginal microbiota. In this work, we developed a novel computational approach and performed taxonomic classification of vaginal microbiota samples stratified longitudinally (Term/PTB) to observe compositional disparities and find underexamined microbes that may be contributing to PTB. Furthermore, we carried out a correlational analysis to build a microbial co-interaction network and investigated the functional implications of the genes present in both Term and PTB samples. The co-occurrence network revealed that Lactobacillus acts in solidarity to maintain the stability of the vaginal microbiota and did not have strong co-interactions with any of the other microbes. Similarly, microbes with strong interactions with Atopobium, a well-known marker microbe of PTB, were also observed. Additionally, several genes such as PTXA, FANCM, GPX, and DUSP were found to be playing an important role in the occurrence of PTB. This study provides a novel conceptual framework revealing distinct vaginal microbiota signatures that could be potential therapeutic targets for the prevention of PTB.

Development and Validation of the Korean Physical Therapy Work Environment Scale (K-PTWES) (한국형 물리치료근무환경 측정도구 개발 및 평가)

  • Hwa-Gyeong Lee
    • Journal of The Korean Society of Integrative Medicine
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    • 제12권2호
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    • pp.65-76
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    • 2024
  • Purpose : This study aimed to develop and validate a reliable tool, the Korean physical therapists' work environment scale (K-PTWES), for assessing the work environment of Korean physical therapists. The study also sought to examine the validity and reliability of the instrument. Methods : This methodological study involved the development and testing of the measurement tool. The conceptual framework was established through a literature review and in-depth interviews with clinical physical therapists. A total of 40 meaningful statements emerged from this process, leading to the generation of 29 primary items. Following a content validity test, 29 items were selected for the preliminary tool. Data were collected from 220 physical therapists across various job roles and unit types, such as outpatient and inpatient physical therapy rooms in domestic hospitals, with more than one year of experience. The final analysis included data from all 220 physical therapists. Results : Varimax rotated principal component analysis was employed for validities, revealing four factors: organizational support, working system, sustainable development, and relationship with coworkers, explaining a total variance of 54.97 %. The Cronbach's α coefficient for the final tool was .939, indicating high reliability. Conclusion : In this study, we developed a measurement tool reflecting the characteristics of the Korean physical therapists' work environment scale (K-PTWES). Our findings highlight the tool demonstrated both validity and reliability. Utilizing this tool is expected to contribute to understanding the work environment of Korean physical therapists and fostering a healthy work environment. Based on our findings, we recommend, firstly, conducting research on the work environment and related factors of physical therapists working in diverse settings using the K-PTWES. Secondly, future studies should focus on validating the tool's criterion-related validity, as it was not addressed in this research.

Social Work with Marriage Based Immigrant Families: an Application of Empowerment Approach (결혼이민자 가족을 위한 임파워먼트 기반의 사회복지실천 연구)

  • Yoon, Hye-Mee
    • Korean Journal of Social Welfare
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    • 제61권4호
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    • pp.85-108
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    • 2009
  • The quickening pace of international migration in the last twenty years brought fundamental demographic and social changes to the Korean society. Increasing number of marriage-based immigrant families imposes new challenges on social work community; however, the social work community has not been equipped with necessary practice models, sets of skills and professionals with cultural competency. This study aims to explore an integrative framework of social work practice with this client group. Research foci include the profile of marriage-based immigrant families in Korea, available social services at the time, challenges and issues they face, the compatibility of the empowerment based social work practice, and micro/mezzo/macro level concerns that arise for the effective service provision. Challenges among marriage-based immigrant families are converged into personal/familial, community related, and larger social-cultural issues. Empowerment is a multi-dimensional social process to help people gain control over their lives; a process that fosters power in people, for use in their lives, their communities and in their society. Empowerment based social work practice can be the most competent framework for working with multi-cultural families considering their multi-faceted acculturation issues while they navigate thru Korean society. Issues of educating and training of culturally competent social workers are discussed.

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The Political Dynamics of Policy Networks and Advocacy Coalitions in South Korea's Healthcare Policymaking : The 20 Years of Debates to Inaugurate a Single-Payer System (한국에서의 의료보험조합 통합일원화 논의의 정치 : 정책 네트워크, 옹호연합, 그리고 보건의료 정책형성의 동태성)

  • Kim, Soon‐yang
    • Korean Journal of Social Welfare Studies
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    • 제42권4호
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    • pp.61-102
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    • 2011
  • The purpose of this article is to anatomize the political dynamics of South Korea's healthcare policymaking through the integrative analytical framework combining the policy network perspective and the advocacy coalition theory. This framework is expected to be advantageous to the analysis of Korea's turbulent healthcare policy change from a systematic and process-driven point of view. A target of analysis is the two decades of turbulence to transform the health insurance system into a single payer system. Through the analysis, this article tries to illuminate the dynamics of Korea's healthcare policymaking, by connecting environmental context, policy networks, advocacy coalitions, and policy outputs. For a case study, this article classifies the debates to inaugurate a single payer system into four sub-phases and conducts longitudinal comparative research.