• Title/Summary/Keyword: Speech Therapy

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Research on Improvement of Patient Quality and Perception of Hospital Operation Effect after Medical Institution Certification - For Nursing Hospitals and Western Hospitals - (의료기관 인증 후 환자의 질 향상과 병원운영효과 인식도 조사연구 - 요양병원과 양방병원 대상 -)

  • Lee, Hye-Seung;Park, Hyun-Rin
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.559-570
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    • 2020
  • The purpose of this study was to classify the internal members of nursing hospitals and Western hospitals that received the certification system of medical institutions, and to examine the effect of certification on member satisfaction, job stress, hospital operation effect, and improvement of medical services. In nursing hospitals, the certification system was higher in member satisfaction, hospital operation effect, and medical service effect than in Western hospitals, and members of Western hospitals were higher in job stress. In both nursing hospitals and Western hospitals, the satisfaction of members, hospital operation effect, and medical service effect according to certification showed positive (+) results. It is believed that the effect of the certification system has been empirically high in nursing hospitals as mandatory certification from 2013. Therefore, this study aims to contribute to the efficiency of hospital management and improvement of patient satisfaction through continuous quality management of medical care by analyzing the effect of certification system on medical service improvement.

A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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Phonatory Caracteristics of Vwels and Resonant Consonants using the Electroglottography (전기성문파형검사를 이용한 모음과 공명 자음의 발성특성)

  • Choi, Seong-Hee;Nam, Do-Hyun;Lim, Jae-Yol;Lim, Sung-Eun;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.2
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    • pp.133-140
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    • 2004
  • Background and Objectives : Vowels and resonant including nasals and liquid are produced with vocal folds vibration have been used for voice therapy of hyperadduction patients. This study was conducted to investigate phonatory characteristics of vowels and resonant consonants through the EGG measures from Lx. Speech studio (Laryngograph Ltd, UK). Materials and Method : 7 male adults produced sustained vowel /a/, /i/, /u/, nasals /m/, /n/, /${\eta}$/and liquid /I/ and read the sentences (1nasals-liquid sentence, 1 non-nasals-liquid sentence) and tongue-tip trill and humming. Fx(Hz), Ox(%) were obtained of vowels, nasals, liquid and each of the posterior vowel /a/ of /ma/, /na/, /la/, /ha/ with same F0(around F#165Hz) and amplitude (75${\pm}$5db). And also DFx(Hz), DQx(%), CFx(%) and CAx(%) were obtained from reading two kinds of sentences. Results : Qx(%) was the highest in /u/ of vowels, and nasal/n/ of the resonant consonants and nasals-liquid sentence was higher Qx than non-nasals-liquid sentence but significant differences were not found. Qx(%) of the posterior vowel /a/ of nasal consonants/n/ was higher than in the isolated vowel/a/ and other posterior vowel of resonant consonants and fricatives /h/. Regularity or periodicity and higher Qx were observed in the nasals-liquid sentence than non-nasals-liquid sentence in graphs of QxFx & CFx produced by Quantiative analysis. In the nasalance score, /u/vowel was significant higher among the vowels and /I/ liquid was significant lower among the resonant consonants and nasals-liquid sentence is higher than non-nasals -liquid sentence. CQ(%) was not significantly correlated with nasalance(%). Conclusion : These findings might signify resonant phonation was not correlated with nasalance.

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Reconstruction of Hard Palatal Defect using Staged Operation of the Prelaminated Radial Forearm Free Flap (부분층 피부이식으로 전판상화된 전완유리피판을 이용한 경구개 결손의 재건)

  • Choi, Eui Chul;Kim, Jun Hyuk;Nam, Doo Hyun;Lee, Young Man;Tak, Min Sung
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.53-57
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    • 2010
  • Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

Comparison of Acoustic Parameters According to the Section of Analysis in Sustained Vowel Phonation (모음연장 음성 샘플의 분석 구간에 따른 음향학적 파라미터 비교)

  • Shin, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.269-274
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    • 2017
  • This study aimed to investigate the acoustic differences that occur in diverse sections of sustained vowel phonation, which is often used in an objective speech analysis of voice disorder patients. The subjects included 17 voice disorder patients (vocal nodules) and 12 normal individuals without any voice disorder. The participants' sustained vowel phonation of /a/ was divided into onset, middle, and offset, and the jitter, shimmer, and NHR in each section were analyzed using the MDVP(Multi-Dimensional Voice Program). The Friedman test and post hoc analysis were used. In the vocal nodules group, the jitter, shimmer and NHR were significantly higher in the off section of sustained vowel phonation than in the middle section, and there were no significant differences between the beginning and middle sections. In contrast, in the group of normal individuals, there were no significant differences between any of the sections. The values of the acoustic parameters according to the section of analysis in the sustained vowel phonation are different and the vocal in the end section is significantly more unstable than that in the middle section. The results of this study will be useful for selecting the sections to be analyzed in sustained vowel phonation and interpreting the results of the analysis.

Arithmetic Fluctuation Effect affected by Induced Emotional Valence (유발된 정서가에 따른 계산 요동의 효과)

  • Kim, Choong-Myung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.185-191
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    • 2018
  • This study examined the type and extent of interruption between induced emotion and succeeding arithmetic operation. The experiment was carried out to determine the influence of the induced emotions (anger, joy, and sorrow) and stimulus types (picture and sentence) on the cognitive process load that may block the interactions among the constituents of working memory. The study subjects were 32 undergraduates who were similar with respect to age and education parameters and were especially instructed to attend to induced emotion by imitation of facial expression and to make a correct decision during the remainder calculation task. In the results, the stimulus types did not exhibit any difference but there was a significant difference among the induced emotion types. The difference was observed in slower response time at positive emotion(joy condition) as compared with other emotions(anger and sorrow). More specifically, error and delayed correct response rate for emotion types were analysed to determine which phase the slower response was associated with. Delayed responses of the joy condition by sentence-inducing stimulus were identified with the error rate difference, and those by picture-inducing stimulus with the delayed correct response rate. These findings not only suggest that induced positive emotion increased response time compared to negative emotions, but also imply that picture-inducing stimulus easily affords arithmetic fluctuation whereas sentence-inducing stimulus results in arithmetic failure.

Effects of Nutrient Intake on Oral Health and Chewing Difficulty by Age Group (연령층별 구강건강과 저작불편이 영양소 섭취에 미치는 영향)

  • Kim, Seol-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.202-209
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    • 2018
  • This study analyzed the effects of the nutrient intake on oral health and chewing difficulty according to the age group. The subjects were 5,855 participants of the third Korea National Health and Nutrition Examination Survey(KNHANES VI), 2015, Korea Centers for Disease Control and prevention and aged 20 years and over. The data were analyzed using SPSS Ver 21.0, classified as the difficulty in chewing group (DC) and no difficulty in chewing group (NDC). As a result, the DC rates were 5 times higher in the 60+ year age group (39.5%) than in the 20-39 year age group (8.1%). The DC group were experience periodontal disease (33.4%), dental caries (30.1%), diabetes (41.8%), myocardial infarction (57.3%), arthritis (44.0%), asthma (48.0%), and depression (41.9%). In addition, 86% of the DC group were experiencing speech problems. The DC group had significantly lower intakes (1446.59g), than the NDC group (1666.62g), and the protein, carbohydrate, dietary fiber and other dietary intake were significantly lower. These findings suggest that the chewing difficulty is related to the nutrient intake, and psychological status in the elderly DC group. Therefore, the care of chewing difficulties is essential for the elderly to maintain a healthy lifestyle. Accordingly, oral care and myofunctional therapy are needed to maintain oral health.

Words for Numbers and Transcoding Processes Reflected by ERPs during Mental Arithmetic (수 연산과정에서 ERP로 확인된 숫자어휘와 부호변환 과정)

  • Kim, Choong-Myung;Kim, Dong-Hwee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.2
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    • pp.689-695
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    • 2010
  • The effect of the code conversion process of Korean script (Hangul), also known as words for numbers, was investigated using event-related potentials (ERPs) during mental arithmetic operations. Study subjects were asked to determine whether the arithmetic results of a given target stimuli were correctly matched. Visual inspection and statistics of mean ERPs showed stimulus type-dependent processing rather than task-dependent processing. Results of addition and multiplication tasks revealed that the overall temporal profiles of the Arabic numerals were similar to the Hangul words for numbers. The only exception to this observation was a delayed positive-slope peak occurring around 300 ms, which was likely related to the encoding process of Hangul words for numbers to Arabic-digits, defined as a 'transcoding-related potential.' Source analysis confirmed that the topography of different waveforms for the two conditions was attributed to a single dipole located in the left temporo-parietal area; this area is known to be involved in Hangul words for number processing. These results suggest that the initial processing for encoding words for numbers was followed by arithmetic operations without direct access of internal number representation. Korea Academia-Industrial cooperation Society. The Korea Academia-Industrial cooperation Society. The Korea Academia-Industrial cooperation Society. The Korea Academia-Industrial cooperation Society.

A Case of Mucopolysaccharidosis Type 2 Diagnosed Early through Brain MRI (뇌자기공명영상 검사를 통해 조기 발견된 제2형 뮤코다당증 1례)

  • Lee, Yoon kyoung;Cho, Sung Yoon;Kim, Jinsup;Huh, Rimm;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.87-92
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    • 2015
  • Mucopolysaccharidosis (MPS) is an inherited disease entity associated with lysosomal enzyme deficiencies. MPS type 2, also known as Hunter syndrome, has a characteristic morphology primarily involving x-l inked recessive defects and iduronate-2-sulfatase gene mutation. The purpose of this case report is to provide important clues to help pediatricians identify Hunter syndrome patients earlier (i.e., before the disease progresses). A 30-month-old boy showed developmental delay and decreased speech ability. Physical examinations revealed a flat nose and extensive Mongolian spots. Brain magnetic resonance images (MRIs) showed bilateral multiple patchy T2 hyperintense lesions in the periventricular and deep white matter, several cyst-like lesions in the body of the corpus callosum, and diffuse brain atrophy, which were in keeping with the diagnosis. Based on these findings, the patient was suspected of having MPS. In the laboratory findings, although the genetic analysis of IDS (Iduronate-2-sulfatase) did not show any pathogenic variant, the enzymatic activity of IDS was not detected. We could confirm the diagnosis of MPS, because other sulfatases, such as ${\alpha}$-L-iduronidase, were detected in the normal range. Early enzymatic replacement therapy is essential and has a relatively good prognosis. Therefore, early diagnosis should be made before organ damage becomes irreversible, and brain MRIs can provide additional diagnostic clues to help distinguish the disorder.

Fiberscopic and Electromyograpic Study on Laryngeal Adjustments for Syllable-final Applosives in Korean (한국어의 음절말 내파음의 후두조절 -화이비스코프 및 근전도에 의한 관찰-)

  • Park, Hea-Suk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.16 no.1
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    • pp.53-67
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    • 2005
  • It is known that Korean stop consonants in syllable-initial position are of three types : lax, aspirated and forced (or unaspirated). In syllable-final position, however, these three different types are merged to a single type with the same place of articulation, although the original three-way distinction is preserved in Korean orthographic (Hangul) system. Thus the syllable-final stops are phonetically realized as voiceless "applosives" which are characterized by the absence of oral release. The aim of the present study is to investigate the laryngeal adjustments for these syllable-final stops in various phonological conditions by using fiberscope, and, is to further investigate electromyographically the laryngeal adjustments for Korean stops both in the syllable-initial and final positions in various phonological conditions. The results can be summarized as follows : 1. In the case of syllable-initial stops, the glottal widths in each three types of the Korean stops during the articulatory closure are clearly different. And the pattern of thyroarytenoid(VOC) activity appeared to characterize the three different types of Korean stops. 2. The basic laryngeal feature of the Korean syllable-final applosives is characterized by a small degree of glottal opening which begins at or slightly after the oral closure. 3. In the case, syllable-final stop followed by the copula "ita", the syllable- final stop is pronounced as the stop consonant at the initial position of the following syllable containing the vowel[i], the underlying features of three-way distinction for the stops in the Korean orthographic(Hangul) system being manifested at the laryngeal adjustment. 4. In the case of the final applosives followed by the initial stops and fricatives, the laryngeal feature of the final applosives appears to be assimilated by that of the following consonant irrespective of the difference in the place of articulation, as far as the glottal abduction/adduction is concerned. It is clearly demonstrated in the case of syllable-initial stop that thyoarytenoid(VOC) activity is suppressed for the production of the stop consonants in question, the degree of which is slightest for the forced type and most marked for the aspirated type, while it is moderate for the lax type.

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