• 제목/요약/키워드: assessment of disability

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The Risk of Cardiovascular Disease and Diabetes in Rheumatoid Arthritis Patients: A Propensity Score Analysis (류마티스관절염 환자의 심혈관 질환 및 당뇨병 위험분석: a propensity score analysis)

  • Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.109-114
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    • 2019
  • Background: Rheumatoid arthritis (RA) is a systemic inflammatory disease that manifests as joint damage or athletic disability via sustained inflammation of the synovial membrane. The risk of cardiovascular disease (CVD) is higher in RA patients. This study aimed at evaluating the association between CVD comorbidities and RA by comparing a pharmacotherapy group with a non-pharmacotherapy group. Methods: Patient sample data from the Health Insurance Review and Assessment Service (HIRA-NPS-2016) were used. Inverse probability of treatment weighting (IPTW) using the propensity score was used to minimize the differences in patient characteristics. Logistic regression analysis was used to evaluate the risk of CVD comorbidities. Results: The analyses included 1,207,213 patients, of which 33,122 (2.8%) had RA. The odds ratios (OR) of CVD comorbidities were increased in RA patients; ischemic heart disease (IHD: OR 1.75; 95% CI 1.73, 1.77), cerebral infarction (CERI: OR 1.28; 95% CI 1.26, 1.30), hypertension (HTN: OR 1.44; 95% CI 1.43, 1.45), diabetes mellitus (DM: OR 2.04; 95% CI 2.03, 2.06), and dyslipidemia (DL: OR 3.49; 95% CI 3.47, 3.51). The ORs of IHD, CERI, HTN, and DM in the traditional DMARD and biologic treatment groups were decreased, compared with those in the non-pharmacotherapy group. Conclusions: Thus, CVD risk was higher in RA patients, considering age, sex, and socioeconomic status. Appropriate pharmacotherapy could decrease the risk of CVD comorbidities in RA patients.

Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial

  • Elsaman, AM;Hamed, A;Radwan, AR
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.114-123
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    • 2021
  • Background: Evaluation of the effectiveness of caudal epidural injection on pain, spine mobility, disease activity, and activity of daily living in axial spondyloarthritis (SpA) patients. Methods: A total sample of 47 patients were registered in this study. They were randomly assigned into 2 groups; Group I received caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone, whereas Group II did not receive any injections. All participants fulfilled the ASAS criteria for axial SpA. Outcome measures were as follows: visual analogue scale, Oswestry disability index (ODI), modified Schober test, lateral lumbar flexion, and Ankylosing Spondylitis Disease Activity Score (ASDAS) with assessment at baseline, 2 weeks, and 8 weeks post-treatment. This clinical trial was registered on clinicaltrials.gov under the number NCT04143165. Results: There was a significant difference between both groups regarding pain, ODI, spine mobility and ASDAS scores in favor of group I. This effect was at its maximum after 2 weeks. Despite the decline of this effect after 2 months, the difference between the groups remained significant. Higher disease activity, younger age, and shorter disease duration were associated with better outcomes. Conclusions: Epidural injection of lidocaine and triamcinolone is a cost effective and a practical technique for controlling pain, as well as improving the function of the spine and disease activity scores in axial SpA patients with acceptable complications and relatively sustained effect.

Development and Evaluation of a Joint Health Self-management Program for the Elderly with Knee Osteoarthritis in Communities: Applying the IMB Model (재가 무릎 골관절염 환자의 관절건강 자가관리 프로그램 개발 및 효과: IMB 모델 적용)

  • Kim, Young-il;Park, Jeong Sook
    • Research in Community and Public Health Nursing
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    • v.28 no.1
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    • pp.55-68
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    • 2017
  • Purpose: The purpose of this study is to develop and evaluate a joint health self-management program for knee osteoarthritis elders in communities. Methods: This program was developed based on the IMB (information-motivationbehavioral skills) model. The program methods include education, setting and achieving goals, sharing experiences, telephone counseling, and self-monitoring. The topics of the program include joint assessment, exercise, massage, joint protection, medication, depression management, diet, and healthcare approach. The research was conducted following the principles of the nonequivalent control group pretest-posttest design. Participants were 26 subjects in the experimental group, and 27 subjects in the control group. The experimental group participated in the self-management program, and the control group received general education. Results: Both post-test scores of personal motivation, social motivation, behavior skill, self-management behavior, joint pain, joint stiffness, physical function disability, right knee extension, left knee extension, and depression were significantly different between the experimental group and the control group. Conclusion: The results of the study can be used to develop and standardize a systematic joint health self-management program. Further research is highly recommended to develop a strategy to continuously facilitate self-management of osteoarthritis patients' procedures.

Analysis of Functional Independence Status and Home Care Needs among Stroke Patients (뇌졸중 환자의 기능적 독립 상태(FIM) 및 가정간호 요구도 분석)

  • Jeon, Eun-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.2
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    • pp.149-156
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    • 2005
  • Purpose: The purpose of this study was to analyze functional independence and need for home nursing care in stroke patients. Method: This was a descriptive study. The subjects comprised 117 stroke patients who were supposed to discharge in less than a week. The instruments used for this study were the functional independence measure(FIM) and the need assessment for home nursing care of stroke patients. The data were analyzed using frequency, mean, t-test, ANOVA, and Pearson correlation coefficient. Results: Pearson correlation analysis revealed that there were negative correlations between subcategories of the FIM and the need for home nursing care in stroke patients. Especially, in case of the subjects who recorded lower scores at self-care they showed higher needs for home nursing care in the domain of physical problem and rehabilitation. Conclusion: For the operation of the home nursing care, the protocol for home nursing care is needed to the stroke patients living at home. The FIM instrument is recommended as a useful scale in order to assess the disability for the stroke patients and the need for home nursing care because this one has correlation with the scale of need for home nursing care.

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Assessing the Functional Status of Acute Stroke Patients using ICF Core Set-short Form (단축형 ICF 핵심지표로 측정한 뇌졸중 환자의 기능상태)

  • Kang, Jiyeon;Gong, Ju;Park, Mi-Jin;Lee, Yeo-Won;Kim, Yuri
    • Journal of muscle and joint health
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    • v.20 no.1
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    • pp.22-30
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    • 2013
  • Purpose: The International Classification of Functioning, Disability and Health (ICF) model was proposed by the World Health Organization for enhancing interdisciplinary communication. The purpose of this study was to examine the functional status of acute stroke patients using ICF core sets-short form. Methods: A set of 15 ICF items on functional status was used by nurses for their daily nursing assessment on functional status in 44 acute stroke patients in a university hospital. Results: The highest level of function was "consciousness", while the lowest was "defecation". Compared with functional status on the first day, consciousness, ingestion, language (mental), and defecation functions were significantly improved on the 14th day. However, there was no significant changes in items on activity and participation or environmental functions. Conclusion: These findings suggest that the function-specific nursing interventions for acute stroke patients need to be developed. Future research needs to test the usefulness of ICF items as an measurement tool.

A Study to Validate the Korean Child Development Review (0-5세를 위한 한국형 영.유아 발달 선별검사(K-CDR)의 타당성에 대한 연구)

  • Shin, Hee-Sun;Kim, Jeong-Mee;Lim, Seong-Or
    • Child Health Nursing Research
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    • v.13 no.2
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    • pp.222-229
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    • 2007
  • Purpose: This study was done to evaluate the validity of the Korean - Child Development Review in screening children with developmental risks. Method: The participants in the study were 172 children aged 6-75 months old and their parents. Data were collected by questionnaire or interview. Korean Denver II and Bayley test were administered with K-CDR for validation of children who were referred for developmental assessment at D University Hospital or public health center. The data were analyzed using correlation, $X^2$ test, and cross tab analysis. Results: There was a significant relationship between the K-CDR and Korean Denver II. The correlation coefficients were .42 to .61 by developmental sector. The sensitivity and specificity of K- CDR were .84 and .66 respectively when "abnormal" with MDI of Bayley test defined as lower than 85 the score which was used as a diagnosis of developmental delay. The responses to 6 questions for parents showed significant differences according to 3 groups by developmental state. Parents of children in the developmental disability group more frequently checked problems from the 26 problem checklist about their children's development and behavior. Conclusion: The results show that K-CDR is valid and has good sensitivity and moderate specificity in screening developmental delay.

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The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

Experiments on Egress of Persons with Mobile Disability in Train Car (철도차량에서의 지체장애인 피난 실험)

  • Kim, Jong-Hoon;Kim, Woon-Hyung;Roh, Sam-Kew;Lee, Duck-Hee;Jung, Woo-Sung
    • Journal of the Korean Society for Railway
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    • v.12 no.6
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    • pp.865-872
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    • 2009
  • Korean railroad company is continuously improving the service for the disabled. They also install and reform many facilities for them. However, It is not considered the importance of egress when fire occurred in a cabin Now, Fire hazard analysis and risk assessment are introduced into domestic regulations for improving fire safety performance of train car and railroad facilities. Considering the fact that fire safety evaluation process doesn't fully include disabled person, fundamental egress data for them is very important for life safety aspect. In this paper, Egress experiments and analysis were conducted to measure the movement speed of the disabled with Mugunghwa and Saemaul.

A Model based Vocational Evaluation for People with Psychiatric Disabilities (정신장애인 직업재활모델과 직업평가 - 직업기능척도 개발을 위한 예비연구 -)

  • Lee, Seong-Gyu;Kim, Sang-Hee
    • Korean Journal of Social Welfare
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    • v.54
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    • pp.123-147
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    • 2003
  • It is well known that one of essential features of psychiatric disability is vocational impairment. Since the year of 2000 when psychiatric disability was declared as one of disability categories in Korea, vocational rehabilitation programs have been actively administered. At this point, it is compelling that vocational evaluation serves as a means of screening out the most promising candidates, identifying their vocational deficits and strengths, designing the individualized vocational interventions, and evaluating vocational outcomes. Still, vocational evaluation for people with psychiatric disabilities has been more problematic than for any other group with disabilities. The authors argued that vocational evaluation for people with psychiatric disabilities should be based on a certain vocational rehabilitation model to address those problems. It is because there exists an indispensible relationship between the vocational rehabilitation model and vocational evaluation. In other words, the main purposes, measurement time points, and focus of vocational evaluation may depend on which of vocational rehabilitation models to make a choice of. In addition, the vocational rehab model(i.e., vocational readiness model or graduation model) underlying traditional vocational evaluation does not seem to work for people with psychiatric disabilities. Authors argued that accelerating model fits for psychiathric characteristics which are often unpredictable and turbulent. As a preliminary step of developing vocational functioning instrument incorporating the demand characteristics of the accelerating model, post-hoc analyses were done on data from a vocational functioning measure and the results were critically examined from viewpoints of accelerating model. For these purposes, discussions were made about a) general functioning of vocational evaluation, (b) relation between vocational rehabilitation model and vocational evaluation, (c) the reasons why the accelerating model is more appropriate to the characterstics of psychiatric clients than the graduation model, (d) post-hoc analytic results reviewed from viewpoints of accelerating model-based vocational evaluation This study is significant in that it attempted model-based, model-specific vocational evaluation as a preliminary step for developing vocational functioning assessment instruments ill future.

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The Domestic Trend of Failed Back Surgery Syndrome: Definition, Treatment Trials and Instruments for Assessment (척추수술 실패 증후군에 대한 국내 연구 동향: 정의, 치료 방법, 평가 도구를 중심으로)

  • Choi, Hee-Seung;Cha, Yun-Yeop;Park, Won-Hyung;Shin, Woo-Suk;Jung, Dong-Hoon;Son, Seol-Ki;Kim, Jong-Su;Kim, Shin-Woong;Kim, Se-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.41-48
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    • 2014
  • Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.