• Title/Summary/Keyword: Patient with disabilities

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Subjective and Objective Caregiver Burden in Parkinson's Disease

  • Kim, Keum-Soon;Kim, Bog-Ja;Kim, Kyung-Hee;Choe, Myoung-Ae;Yi, Myung-Sun;Hah, Yang-Sook;Chung, Sun-Ju;Kwon, So-Hi
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.242-248
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    • 2007
  • Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

BEHAVIOR MANAGMENT TECHNICS FOR AUTISTIC CHILDREN : A CASE REPORT (자폐의 정도에 따른 행동조절법의 적용 : 증례보고)

  • Chung, Saet-Byul;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.525-532
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    • 1998
  • The autism is a complex disorder, characterized language impairment, perceptual-motor difficulties, and social disturbance. The autistic children have hyperactivity, lack of communication' lack of cooperation, inappropriate patient/dentist interaction, so they require professionally recognized behavioral management technique during dental treatment such as behavior modification, phamacological agents, and general anesthesia. A behavior management technique can be chosen by factors such as the severity of autism and possible accompanying disabilities, degree of cooperation, oral and general conditions of children. A non-pharmacological behavior modification may be selected for the autistic children who are able to communicate with dentist with mild dental caries, without compromised medical history. In case of excessively hyperactive, destructive, antisocial, and/or severe communicative disorder, a sedation technic with chloral hydrate, hydroxyzine, midazolam or nitrous oxide gas might to be performed. General anesthesia is preferred for severe communicative and/or behavioral disorder, elder age, excessive dental care need, and living a remote area.

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The relationship between disability and clinical outcomes in maintenance dialysis patients

  • Kang, Seok Hui;Do, Jun Young;Kim, Jun Chul
    • Journal of Yeungnam Medical Science
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    • v.38 no.2
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    • pp.127-135
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    • 2021
  • Background: Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients. Methods: This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization. Results: The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend). Conclusion: Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

A Review of Clinical Shoulder Assessment Scales (견관절의 임상적 평가도구에 관한 고찰)

  • Yang, Dong-Hoon;Kim, Kun-Hyung;Kim, Haeng-Beom;Choi, Yang-Sik;Park, Young-Bae
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.123-135
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    • 2007
  • Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.

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Hemiarthroplasty for Distal Humerus Fracture: A Systematic Review and Meta-analysis for Functional Outcome

  • Kwak, Jae-Man;Kholinne, Erica;Sun, Yucheng;Lee, Gwan Bum;Koh, Kyoung Hwan;Chun, Jae-Myeung;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.120-126
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    • 2018
  • Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

Nursing Experience of Caring for Extremely Low Birth Weight Infants (초극소미숙아 돌봄을 통한 간호경험)

  • Kim, Hack-Sun;Choi, Kyung-Sook;Kim, Jung-Sook;Lee, Joo-Hyun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.2
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    • pp.257-266
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    • 2011
  • Purpose: The aim of this study was to elucidate the themes involved in a nursing experience of caring for extremely low birth weight infants (ELBWIs) in a neonatal intensive care unit (NICU). Methods: Interviews with 6 nurses in various positions and observations in a level III NICU were conducted. The transcribed interview contents and observational notes were reviewed to analyze the data and conceptualize major themes. Results: Three major themes were identified: the fears expressed by the nurses regarding taking care of ELBWIs, reasons for persistent fears, and overcoming fears and gaining intuition. Nurses were afraid of the following factors: the physical fragility of the infants; the possibility of developing disabilities in the future; and the rapid changes in infants' physical condition. These fears were reduced when nurses had developed intuition and confidence in taking care of ELBWIs through various situational experiences. Conclusion: NICU nurses may benefit from obtaining more opportunities to participate in various learning experiences with simulated nursing situations in a variety of patient groups. Applying knowledge and skills into various nursing situations in an integrative way may contribute to enhancing nurses' confidence in nursing practice.

A Study on the Clothing Inconvenience Levels for the Clothing Improvement of Female Arthritis Patients (여성관절염질환자의 의복개선을 위한 의복불편정도에 관한 연구)

  • Han, Seung-Hee
    • Journal of Fashion Business
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    • v.12 no.5
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    • pp.111-125
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    • 2008
  • The purpose of this study is in the investigation to relieve into the clothing inconvenience levels and to need by arthritis patients who experience clothing difficulties in daily living even without showing conspicuous physical disabilities. For this study, personal interviews were carried out with 151 female arthritis patients, using a questionnaire form consisting of a total of 206 items. Data analysis were done with spss 12.0 for the frequency analysis, cross tab analysis, t-test, and ANOVA. The findings are as follows. 1. The survey subjects were diverse in their age from 20s to 60s and 18.5% of them have need of other's assistance at the time of getting dressed or undressed of clothing. The knee part was felt to be the most uncomfortable, causing the inconveniences in wearing pants or panties. 2. The investigation into the inconvenience levels at the time of dressing or undressing of clothing was indicated that the wearing of pants was the hardest movement to arthritis patients, as the items relating to the movements for putting feet into or pulling them out of pants and those for raising pants over the hip were also accompanied by the feeling of pains. In addition, the aged arthritis patients felt the clothes-wearing movements more difficult. 3. The survey on the kind and inconvenience levels for the clothes currently being worn showed the highest wearing ratio for the pants, which were pointed out to be the most inconvenient. 4. As for the clothing improvement, the needs were located as a whole in the sufficiency in measures of pants crotch and circumference items, the flexibility in materials, the short length of pants, or the front clearance.

International Trends in Wheelchair Power Assist Add-ons Development (휠체어 동력 보조장치 개발 국제 동향)

  • Suk-Min Lee;Ki-Won Choi;Inhyuk Moon;Sangsoo Park
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.2
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    • pp.143-150
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    • 2023
  • As Korea's per capita income increases, participation in various leisure activities to improve the quality of life of the disabled is encouraged. However, in order to participate in leisure activities, movement to the place where the leisure activities are performed must be preceded, so interest in means of transportation for leisure activities of the disabled is increasing. Since manual and electric wheelchairs have their respective disadvantages as means of transportation for leisure activities, interest in power assisting devices for wheelchairs combining the functions of electric wheelchairs with manual wheelchairs is increasing. In this study, the FDA approval process of wheelchair power-assistance products was investigated, and the characteristics of side-attached, front-attached, downward-attached, and rear-attached types of power assist devices for wheelchairs wheelchair in countries around the world were identified. These information will be of great use in helping the disabled and their assistants in Korea to choose the optimal product according to the patient's condition. More usability tests and clinical case studies are needed so that people with disabilities can choose a power assist device suitable for them.

The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review (다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰)

  • Cho, Eun-Hee;Song, Hyun-Eun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.54-64
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    • 2019
  • Objective : The purpose of this study is to study the effects of multisensory environment interventions, to provide information about clinical applications, and to aid South Korean research on the multisensory environment. Methods : PubMed, Cochrane, and Google Scholar were used to search for papers published from 2008 to 2018. The main search terms were "multisensory environment" and "snoezelen", a total of 10 foreign research articles were selected. And they were summarized according to Patient, Intervention, Comparison, Outcome (PICO). Results : Among the 10 papers, 6 included participants with dementia. The other studies examined patients with intellectual disabilities, patients with schizophrenia, and pregnant women. The study periods ranged from 3 weeks to 10 months. Most of the interventions included 2 or 3 sessions per week. The duration of each intervention session was 30 to 60 minutes. The dependent variables were psychological factors (such as anxiety and depression), social factors (such as quality of life), and cognitive and physical domains. The multisensory environment used for the interventions in the studies consisted of visual, auditory, and tactile senses, as well as additional olfactory and taste sensations, and vestibular sensations. Conclusion : In the future, the research should be applied to various target groups, especially children, who are interested in multisensory environmental intervention in South Korea.

Fundamental Idea and Actuality of the Medical Dispute Mediation Act (의료분쟁조정법의 기본이념과 현실)

  • Kim, Min-Joong
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.43-83
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    • 2013
  • Medical treatment has great potential for conflict. Even the best-trained doctors can commit medical malpractice that result in continuing physical or mental disabilities or even death. Medical conflicts have been increasing over years. The medical conflicts between patient and medical professionals that result from medical professionals' mistakes are often fueled by a violation on the pretext of the injuries form medical malpractice and can lead to litigation. The litigation usually cost a lot of money and time. The extension of the litigation period as well as expensive cost and lack of medical knowledge placing a great burden on patients. Alternative Dispute Resolution(ADR) is more efficient than litigation. In 1988, the medical dispute mediation system has been introduces as the Act on Remedy for Damage from Medical Accident and Medical Dispute Mediation by Korean Medical Association came into effect after 23 years of enactment efforts. Medical Dispute Mediation Act(hereinafter referred to as the "MDMA") has finally entered into force from 8 April 2012. The purpose of the MDMA is to promptly and fairly redress injuries caused by medical malpractice and create a stable environment for medical services of public health or medical professionals by providing for matters regarding the mediation and arbitration of medical disputes(MDMA ${\S}1$). In an effort to secure the fair, speedy and inexpensive resolution of every malpractice case, the Korea Medical Dispute Mediation and Arbitration Agency(hereinafter referred to as the "K-MEDI") was established. Following the MDMA, the K-MEDI shall endeavor to ensure the medical dispute mediation or arbitration proceedings are conducted in a prompt, fair, and efficient manner, and patients and medical professionals shall attend proceedings in good faith with mutual trust and understanding when they participate in medical dispute mediation or arbitration proceedings.

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