Journal of the Korean Academy of Clinical Electrophysiology
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v.2
no.2
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pp.61-76
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2004
This research tries to find out the methods to enhance the rehabilitation ability of Cerebro Vascular Accident(CVA) patients and their family members. For this purpose, the authors identify the factors that may affect the medical rehabilitation process as well as the rehabilitation itself. Furthermore, the current status of the rehabilitation ability and the desires of CVA patients and their family members are surveyed in this research. The results of this research are as follows: Firstly, the surveyed CVA patients, most of whom are over fifties in the age, have cerebral infection and hemorrhage in a numerical order. The survey showed that the larger cities they live in, the more CVA occur to them. Secondly, the survey for the treatment cost demonstrated that the lower are their living level and their education level, the more pressure is put on the CVA patients and their family. The statistical data proved this conclusion is reasonable. Thirdly, as for the safisfaction for the rehabilitation treatment, the statistical survey showed that it is directly proportional to their financial income. Moreover, those who have lower income generally want the rehabilitation services from a public health center. On the other hand, those who have higher income want the home therapy services.
Objective : The purpose of this study was to verify the effectiveness of home-visit occupational therapy in stroke patients. Methods : Two patients with stroke who applied for home-based occupational therapy services at a health center in Seoul were enrolled. The home-visit occupational therapy program evaluates the subject's daily living, task performance, cognitive, and emotional functions, sets occupational therapy goals and plans interventions based on a client-centered approach. Occupational therapy programs consisted of 12 sessions based on the client's major problems. Results : COPM scores improved in both cases, there was an improvement in COPM scores, and in Case 2 there were improvements in MBI and K-MMSE scores. There was also an improvement in KGDS scores in Case 1. Conclusion : Home-visit occupational therapy was found to be effective in improving daily activities, cognition, and mental function of stroke patients. During home and community integration, continuous and continuous rehabilitation services need to be activated from institutional rehabilitation to community-based rehabilitation. Active home-visit occupational therapy is needed to promote physical, cognitive, mental and social access in stroke patients discharged from hospitals.
Background: Researchers have previously commenced examining the degree of concordance between parent proxy and child self-reports on health-related quality of life (HRQOL) of many disease and impairment populations. Objects: To explore the differences between parent proxy and child self-reports on the HRQOL using Korean version of KIDSCREEN-10 questionnaires for applying to elementary school children and their parents who participated for a school-based wellness program. Methods: The focus groups were recruited for a school-based wellness program by implementing the following wellness services: 1) referring to a screening session for detecting potential posture-related musculoskeletal problems and 2) recommending home exercise programs. Before a primary field testing for the program, two focus groups were formed with a group of 9 parents and their 9 elementary school children aged 8-10 years of age. The parent proxy and child self-report versions of KIDSCREEN-10 questionnaires were administered to both groups after completion of the wellness program. Item level Rasch rating scale analysis was applied to compute logit scales of KIDSCREEN-10 questionnaire. Intraclass correlation coefficients (ICCs) and scatterplot of item difficulty between two reports were analyzed. Results: For fit statistics of parent proxy report, all items except 4 items (i.e., psychological well-being, mood/emotions, self-perception, parent relation) were found to be acceptable. For fit statistics of child self-report, all items except 3 items (i.e., psychological well-being, autonomy and home life) were acceptable. The relationship between two reports using ICCs were ranging from weak to very strong at p = 0.05 (i.e, ICCs = 0.011 to 0.905). Scatterplot analysis between two reports showed a major disparity on self-perception item at 95% confidence intervals. Conclusion: Both item level analyses and ICC comparisons provided a disparity between parent proxy and child self-reports of the HRQOL on self-perception item after competing a school-based wellness program. Therapist should consider the item as part of the HRQOL assessment.
To survey the recognition of Community Based Rehabilitation(CBR) by Public Health Center(PHC) Physical Therapists in Seoul Province. This study analysed general characteristic of Physical Therapists and cognition, participation, education, problems and requirements for CBR. The subjects of this study were 31 therapists who work at PHC in Seoul Province and Seoul City Childerns Municipal Hospital. Data was collected for 18 days from April 13 to 31, 1998 and results computed from 25 responses. First, Female therapists outnumber males. The age category 30 to 35 old represented 44.0% of the total number studied. 48.0% of therapists had worked more than 7 years and therapists usually 84.0% worked from 3 to 4 years at the PHC. Junior colleage graduates were 72.0%, and respondents with family responsibility were 52.0%. Second, Recently pain control and therapeutic exercises has become the major requirement of patients at PHC(56.0%). If the offered expanded services, a rehabilitation programe at PHC(36.0%) was highly. When asked about a working guide book, nobody had one. Third, 64.0% of therapists were aware of the present level of CBR, 28.0% of them had gotten an information from newspaper and mass media. Fourth, For CBR, 72.0% had positive ideas in which they could participate. 56.0% wished to compose a team of various rehabilitation specialists. 52.0% wished for the meeting day to be flexible and 64.0% desired to meet once or twice a week. Fifth, Almost all(92.0%) desired more educational opportunity about CBR. Example, once or twice a year(48.0%) and training period of 4 to 7 day(44.0%). They wanted to learn theory and parctice together(88.0%) and 48.0% wanted national mutirehabilitation center as a educational managing organization. Sixth, The most important requirement for accomplishing CBR by Physical Therapists was job security and adequate number of therapists(48.0%). Required number of physical therapists in the PHC was 3(52.0%). The cooperative agency should be the distict govement(32.0%) and community welfare center of the disabled persons(32.0%). Factors inhibiting the execution of CBR were lack of physical therapists(56.0%), and equipments for pain control and for therapeutic exercises(68.0%).
In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.
Journal of The Korean Society of Integrative Medicine
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v.12
no.3
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pp.179-188
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2024
Purpose : The home-visiting exercise guidance service is a component of the community-based integrated care policy in District J of Busan Metropolitan City. This study aims to investigate the effects of the service provided by physical therapists on depression, pain, and balance among the elderly. Methods : Three elderly individuals were selected as study participants. Depression was assessed using the beck depression inventory (BDI) and the short geriatric depression scale-Korea (SGDS-K). Pain was evaluated using the visual analog scale (VAS). Balance was assessed using the berg balance scale (BBS), functional reach test (FRT), and timed up and go test (TUGT). The evaluation data were compared by averaging the values from the first and eighth sessions. Additionally, the overall satisfaction with the home-visiting exercise guidance service was surveyed. Results : In the depression assessment, the beck depression inventory score decreased (by 16.67±5.69 points), and the short geriatric depression scale score decreased (by 4.67±2.52 points). The visual analog scale score for pain decreased (by 2.67±0.58 points). In the balance assessment, the berg balance scale score increased (by 7.67±2.52 points), the functional reach test distance extended (by 4.67±0.58 cm), and the timed up and go test time decreased (by 5.33±0.58 s). Overall satisfaction with the home-visiting exercise guidance service was high (4.26±0.14 points). Conclusion : The home-visiting exercise guidance service received high satisfaction ratings from the participants. It was effective in reducing depression and pain while improving balance, potentially reducing fall risk factors among the elderly. These findings suggest that the home-visiting exercise guidance service, delivered by physical therapists, could significantly enhance the quality of life for elderly individuals by addressing issues related to depression, pain, and fall prevention within the community. Consequently, it is recommended that this service be continued and expanded as part of government policy.
Purpose: The purpose of the study was to investigate knowledge and attitudes of students majoring in health-related fields toward automated external defibrillator (AED) and to identify the influencing factors of knowledge and attitudes in AED use among the students. Methods: Data were collected from 346 students and analyzed using descriptive statistics, t-tests, one-way ANOVA, post hoc $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and hierarchical multiple regression analysis, with SPSS Win 20.0 program. Results: Overall knowledge of AED in health-related major students, except paramedics and physical therapy was relatively low while attitudes were at moderate level. There were statistically significant differences in knowledge according to age, grade, major, cardiopulmonary resuscitation (CPR) awareness, exposure to AED and CPR education; and differences in attitude according to major, health status, health awareness, CPR awareness, exposure to AED, and CPR education. Significant factors explained 63% of knowledge on AED (F= 43.96, p<.001) and 37% of attitudes on AED (F= 15.84, p<.001). Conclusion: The study findings suggest that systemic education programs on AED should be implemented during undergraduate curriculum to improve survival rate of sudden cardiac arrest.
Purpose: The purposes of this research were to study the validity of the National Examination based on smart based test(SBT) by 7 types of healthcare occupation. Methods: We conducted a questionnaires survey among 1,219 people including 210 professors for all 7 types of healthcare occupation and 573 clinical specialists ; 436 students from random sampling participated and the reliability of the questionnaire was tested using Cronbach's alpha. Results: Professors from 7 types of healthcare occupation were investigated for their opinions on the introduction of the SBT system ; 65.9% of the professors answered positively on the introduction of the SBT National Examination System, while 40.1% of the clinical experts answered likewise. In particular, professors and the clinical experts recognized altogether that the multimedia questionnaire, being effective for the evaluation of clinical and practical competence of the subjects, enabling the evaluation of various areas and strengthening the school education in clinical practices, the 42.0% of the students from 7 departments answered that the future direction of the national test is in the SBT test system with significant difference (p=.000) found in students majoring in order of Emergency Medical Services, Radiology and Physical therapy, compared to students from other majors, showing the positive response to the SBT system. Conclusion: The results of this study comprehensively evaluated the positive recognition of development of multimedia items and SBT system in national examination of 7 types of healthcare occupation in professors, field specialists and students.
Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.
Hicks-Roof, Kristen;Xu, Jing;Fults, Amanda K.;Latortue, Krista Yoder
Nutrition Research and Practice
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v.15
no.6
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pp.789-797
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2021
BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.
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