• 가정∙방문간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting 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 the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical 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 test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• 재활간호학회지
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• 제6권1호
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• pp.70-78
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• 2003

This study was a quasi-experimental study of nonequivalent control group pretest-posttest design to investigate the effect of rhythmic dance movement training on the physical and psychological functions of the elderly. The data were collected from November, 2001 to February, 2002. The subjects for this study were 34 elderly who was over 65 years old and was living in J city. The elderly selected for this study were: free from heart and pulmonary disease and not regular exercise. The rhythmic dance movement training in watching video tape was rhythmic dance movement and education and supportive care. The rhythmic dance movement was 40-60 intensity, 8 weeks' period, three times a week, 60 minutes a day. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. 2. There was significant difference in the gait speed between the two groups. 3. There was significant difference in the dynamic valance between the two groups. 4. There was no significant difference in the depression between the two groups. 5. There was no significant difference in the Quality of life between the two groups. As shown above, the results of the 8 weeks' rhythmic movement program for the elderly produced positive effects on gait speed, dynamic valance. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

• 대한통합의학회지
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• 제5권2호
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• pp.33-42
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• 2017

Purpose: This study examined the effects of the fumanet exercise program on the cognitive function and fall down-related physical fitness factor in elderly people. Method: The study period was May 2-June 24, 2016. The participants included 20 elderly persons (control group 10, experimental group 10) who registered at the day-care Center in G. City. Descriptive statistics were used for the analysis of the control and experimental groups' general characteristics. The chi-square and Mann-Whitney U tests were conducted to identify the two groups' general characteristics' and dependent variables' homogeneity. The Wilcoxon signed-rank test was used to compare the pre-and post-intervention cognitive function and fall down-related physical fitness factor, and a Mann-Whitney U test was used to analyze the rate of cognitive function and fall down-related physical fitness factor changes between the groups after the intervention. Result: The participants' fall down-related physical fitness factors (balance, gait, leg strength) increased and memory in the cognitive function sub-area improved in the participants who participated in the fumanet exercise program. The amount of change in gait was significantly different between the control and experimental groups. Conclusion: The fumanet exercise program included gait training using the learn, remember and repeat phased steps. Therefore, this study proposes using the fumanet exercise program to improve the elderly's cognitive function and physical fitness factor.

• 재활치료과학
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• 제10권2호
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• pp.23-36
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• 2021

목적 : 본 연구는 지역사회에 거주하는 노인 대상의 그룹 프로그램 연구를 체계적으로 고찰하여 분석하고자 한다. 연구방법 : 2009년부터 1월부터 2019년 12월까지 NDSL, DBPia, Riss, PubMed의 데이터베이스를 이용하여 지역사회 노인 대상의 그룹 프로그램에 대한 논문을 검색하였으며, 1차 검색된 147편의 논문 중 선정기준 및 배제기준에 따라 16편의 논문을 최종 선택하여 연구 대상자 특성, 그룹 프로그램의 세부내용, 중재기간 및 회기, 결과 측정방법, 그룹 프로그램의 효과를 분석하였다. 결과 : 총 16편의 선정된 연구 중 근거수준 III에 해당하는 단일 그룹 사전-사후 연구가 8편(50.0%)으로 가장 많았고, 지역사회 거주 일반 노인 대상의 연구가 5편(25.0%)이었다. 총 16편의 연구에서 적용한 그룹 프로그램의 유형은 10개로 구분되었고, 운동 그룹 프로그램이 4편(25.0%)이었다. 그룹 프로그램 중재 기간은 12주 동안의 중재 기간이 6편(37.5%)이었고, 회기는 8회기와 12회기가 4편(25.0%)이었으며, 그룹 프로그램의 적용 시간은 60분이 7편(43.8%)이었다. 결론 : 본 고찰 연구는 지역사회에서 다양한 인지수준의 노인을 위한 작업치료 그룹 프로그램 개발의 기초자료로 활용될 수 있다.

• 한국보건간호학회지
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• 제16권1호
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• 지역사회간호학회지
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• 제11권1호
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• pp.245-261
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• 2000

Based on the literature, status and role the music therapist in America was reviewed for this study. The process of developing a music therapy program in America suggests to us many things: In America, music therapists have sustained a mutually beneficial status with their clients for, over fifty years. Excellence in academic education and clinical training enable music therapists to continue to provide quality music therapy. The magnitude of change in to music therapy in the United States, however creates the challenge of providing real access to music therapy continues in the future. Music therapy is the use of music in the accomplishment of therapeutic aims: the restoration, maintenance, and improvement of mental and physical health. Music therapists work with individuals of all ages who require special services due to behavioral. social. learning, or physical disabilities. Employment may be in hospitals, clinics, day care facilities, schools, community mental health centers, substance abuse facilities, nursing homes, hospices, rehabilitation centers, correctional facilities, or private practices. The American Music Therapy Association (AMTA) was founded in 1998 as a result of a union between the American Association for Music Therapy (founded in 1971) and the National Association for Music Therapy(founded in 1950). Music therapists are highly qualified professionals who have completed approved degree programs and had clinical training in order to receive Board Certification(MT-BC), with the designation of Registered, Certified, or Advanced Certified Music Therapist(RMT. CMT - or ACMT). AMTA provides several mechanism for monitoring the quality of music therapy programs: Standards of Practice. a Code of Ethics, a system for Peer Review, a Judical Review Board, and an Ethics Board. According to the results of this study, the suggestions were as follows: 1. It is concluded that music therapy as a nursing intervention can be effective for the clients. 2. It is a great challenge to develope a music therapy program for nursing intervention however, it is also task and responsibility to further the development of nursing.

• 가정∙방문간호학회지
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• 제10권1호
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• 재활치료과학
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• 제3권1호
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• pp.31-37
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• 2014

목적 : 본 연구는 국내 장기요양보험서비스를 제공받는 치매환자를 대상으로 다양한 분야에서 이루어진 작업 중심 회상치료 프로그램을 중재 적용한 연구 효과에 대해 검토해보고자 체계적 고찰을 시행하였다. 연구방법 : 2009년부터 2013년 까지 한국교원학술정보원을 통해서 확인되는 논문을 검색하였고 주요 검색용어로는 치매, 시설 서비스, 주간 보호 센터, 회상치료, 작업 중심 프로그램 등의 단어를 사용하였다. 연구결과 : 분석 결과 총 6편의 논문이 선정되었으며 선정된 연구에서의 회상치료는 모두 작업 중심 프로그램을 병행한 집단 회상치료이다. 세부 중재 형태는 의사소통 중심 회상치료, 작업 중심 회상치료로 크게 2가지 형태로 나눌 수 있었다. 치매 환자 대상의 회상치료의 효과는 인지기능 유지 및 회상기능 향상, 우울감소, 문제행동 감소, 의사소통 및 사회적 상호작용 향상, 삶의 질 향상 등 총 5가지 효과가 보고되었으며, 연구의 질적인 측면에서는 적은 대상군, 짧은 연구기간, 추적조사 미시행으로 인해 전반적으로 낮은 수준의 내적, 외적 타당도를 보였다. 결론 : 추후의 연구에서는 보다 많은 수의 대상군의 확보와 추적조사를 통한 지속적인 치료적 효과에 대한 연구가 이루어져야 할 것이며 치매환자 대상의 다양한 형태의 작업 중심 회상치료의 연구가 이루어져야 할 것으로 사료된다.

• 지역사회간호학회지
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• 제10권1호
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.273-281
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• 2013

Purpose: The purpose of this study is to determine the effect of motor imagery training on residual upper extremity strength and activities of daily living of chronic cervical spinal cord injury patients. Methods: Twelve ASIA A B patients, who had more than a 12-month duration of illness and C5 or 6 motor nerve injury level, were randomly divided into experimental group (n=6) and control group (n=6). Patients in the experimental group performed motor imagery training for five minutes prior to general muscle strengthening training, while those in the control group performed general muscle strengthening training only. The training was performed five times per week, 30 minutes per day, for a period of four weeks. General muscle strengthening training consisted of a progressive resistive exercise for residual upper extremity. Motor imagery training consisted of imagining this task performance. Before and after the training, EMG activity using BTS Pocket Electromyography and Spinal Cord Independent Measure III(SCIM III) were compared and analyzed. Results: The residual upper extremity muscle strengths showed improvement in both groups after training. Comparison of muscle strength improvement between the two groups showed a statistically significant improvement in the experimental group compared to the control group (p<0.05). SCIM III measurements showed significant improvement in the scores for Self-care and Transfer items in the experimental group. Conclusion: Motor imagery training was more effective than general muscle strengthening training in improving the residual upper extremity muscle strength and activities of daily living of patients with chronic cervical spinal cord injury.