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A Study on the Stress of Family-Caregivers and Level of Daily Living Performance with Patients of Cerebra Vascular Accident(CVA) (뇌졸중환자의 일상생활 수행수준과 가족원의 스트레스)

  • Cho, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.372-386
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    • 1999
  • The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).

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The Effect of the Cognitive State of the Elderly on the Performance Level in the Activities of Daily Living(ADL) (노인의 인지상태가 일상생활활동 수행정도에 미치는 영향)

  • Kim, Soon-Ja
    • Journal of Korean Physical Therapy Science
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    • v.15 no.2
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    • pp.41-51
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    • 2008
  • Background: The purpose of this study is to determine how the cognitive state of the elderly influences the activities of daily living(ADL) in order to increase their achievement capacity and their ability to exercise this capacity in daily life. The MMSE-K(Mini-Mental State Examination-Korean) was used to evaluate the daily activities and cognitive state of a group of subjects more than 65 years of age. The goal was to understand (1) How their achievement level in their daily activities changes according to the increase and decrease of their cognition points by analyzing and comparing their achievement points in the mental state examination, and (2) What variables influence that daily achievement level. Methods: The survey was conducted by a group of students from AnSan College who were trained for this method of data collection. The group surveyed 224 senior citizens older than 65 to determine their ADL performance. The subjects were selected from Silver Care Centers in the Gyounggi Province area including centers in Suwon, Anyang, Kwachun, and Sanbon City. The subjects were given enough information to fully understand the purpose of the study and the method by which it would be conducted. The survey method was a direct interview: which involved an interviewer reading the questionnaire to the subject and recording the answer. Result: The following results were calculated using SPSS WIN ver. 13.0: In the lower score of the MMSE-K regarding ADL performance (K-MBI) for activities such as individual hygiene, bathing activity, food activity, toilet management, going up stairs, getting dressed ad undressed, controlling stools and urination, walking, and chair/bed movement, most of the subjects responded that they could not perform these activities by themselves (p<.01). In the higher scores for the same activities, most response that they could perform the tasks by themselves (p<.01). In the results of the multiple regression analysis, there influence of the variables for ADL performance (K-MBI) and MMSE-K score was higher for females than males. Conclusion: This study evaluated the cognitive state of the elderly using the MMSE-K, which is the most convenient method, and examined how the cognitive state influences the achievement capacity of the daily lives with other variables. In conclusion, the higher the score on the MMSE-K, the more independent the elders are in the activities of daily living, especially among women more than men.

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In Whom Do Cancer Survivors Trust Online and Offline?

  • Shahrokni, Armin;Mahmoudzadeh, Sanam;Lu, Bryan Tran
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6171-6176
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    • 2014
  • Background: In order to design effective educational intervention for cancer survivors, it is necessary to identify most-trusted sources for health-related information and the amount of attention paid to each source. Objective: The objective of our study was to explore the sources of health information used by cancer survivors according to their access to the internet and levels of trust in and attention to those information sources. Materials and Methods: We analyzed sources of health information among cancer survivors using selected questions adapted from the 2012 Health Information National Trends Survey (HINTS). Results: Of 357 participants, 239 (67%) had internet access (online survivors) while 118 (33%) did not (offline survivors). Online survivors were younger (p<0.001), more educated (p<0.001), more non-Hispanic whites (p<0.001), had higher income (p<0.001), had more populated households (p<0.001) and better quality of life (p<0.001) compared to offline survivors. Prevalence of some disabilities was higher among offline survivors including serious difficulties with walking or climbing stairs (p<0.001), being blind or having severe visual impairment (p=0.001), problems with making decisions (p<0.001), doing errands alone (p=0.001) and dressing or bathing (p=0.001). After adjusting for socio-demographic status, cancer survivors who were non-Hispanic whites (OR= 3.49, p<0.01), younger (OR=4.10, p<0.01), more educated (OR= 2.29, p=0.02), with greater income (OR=4.43, p<0.01), and with very good to excellent quality of life (OR=2.60, p=0.01) had higher probability of having access to the internet, while those living in Midwest were less likely to have access (OR= 0.177, p<0.01). Doctors (95.5%) were the most and radio (27.8%) was the least trusted health related information source among all cancer survivors. Online survivors trusted internet much more compared to those without access (p<0.001) while offline cancer survivors trusted health-related information from religious groups and radio more than those with internet access (p<0.001 and p=0.008). Cancer survivors paid the most attention to health information on newsletters (63.8%) and internet (60.2%) and the least to radio (19.6%). More online survivors paid attention to internet than those without access (68.5% vs 39.1%, p<0.001) while more offline survivors paid attention to radio compared to those with access (26.8% vs 16.5%, p=0.03). Conclusions: Our findings emphasize the importance of improving the access and empowering the different sources of information. Considering that the internet and web technologies are continuing to develop, more attention should be paid to improve access to the internet, provide guidance and maintain the quality of accredited health information websites. Those without internet access should continue to receive health-related information via their most trusted sources.

Functional Evaluation after Modified Brostrom Procedure with Suture Bridge Technique for Chronic Ankle Instability in Athletes (운동선수의 만성 발목관절 불안정성에서 교량형 봉합술을 이용한 변형 Brostrom 술식 후의 기능평가)

  • Park, Ji-Kang;Park, Kyoung-Jin;Cho, Byung-Ki;Im, Chae-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.108-114
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    • 2014
  • Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

A study on environmental status, FIM and Illness intrusiveness of home stayed stroke patients (재가 노졸중 환자의 환경상태, 기능적 독립, 질병으로 인한 장애영향에 관한 연구)

  • Kim, Keum Soon;Roh, Kook Hee
    • 한국노년학
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    • v.25 no.2
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    • pp.143-154
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    • 2005
  • This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.

Energy expenditure measurement of various physical activity and correlation analysis of body weight and energy expenditure in elementary school children (일부 초등학생의 대표적 신체활동의 에너지소비량 측정 및 에너지소비량과 체중과의 상관성 분석)

  • Kim, Jae-Hee;Son, Hee-Ryoung;Choi, Jung-Sook;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.48 no.2
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    • pp.180-191
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    • 2015
  • Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA) (뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구)

  • Cho Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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An Interpretation of the Landscape Meaning and Culture of Anpyung-Daegun(Prince)'s Bihaedang Garden (안평대군 비해당(匪懈堂) 원림의 의미경관과 조경문화)

  • Shin, Sang-Sup;Rho, Jae-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.1
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    • pp.28-37
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    • 2011
  • In this study, the series-poem, Bihaedangsasippalyoung(48 poems for beautiful scene of Bihaedang), written by scholars of Jiphyonjeon for Bihaedang garden of Anpyung-Daegun(Prince Anpyung, 1416-1453), was analyzed focusing on scenery lexeme to interpret the meaning of scenery and gardening culture of Sadaebu(noblemen) during the first term of Chosun Dynasty. The study result is as followings. First, the subtitle of Sasippalyoung(48 poems) written by Anpyung-Daegun while he grew Bihaedang garden on the foot of Inwang Mountain showed repetitive nomativity comparing joining of yin and yang, such as life and form of animal and plan, time and space, meaning and symbolism, etc. Among scenery lexemes, 38 are represented plant and flowers, and 8 are represented gardening ornaments and animals. Second, the names of gardens were expressed as Wonrim, Jongje, Imchon(Trees and Ponds), or Hwawon(Flower garden), or also presented as Gongjeong(Empty garden), Manwon(Full garden), Jungjeong(Middle garden), Huwon(Backyard), Wonrak(Inner court), or Byulwon(Seperated garden) depending on density and location. In addition, there were pavilions and ponds, stepping stones and stairs, a pergola, a flat bench, flowerpots, an artificial hill, oddly shaped stones, wells, aviary, flower beds, or hedges. A gardener was called Sahwa(flower keeper), planting and gardening of garden trees were called Jaebae(cultivation), a pond island was called Boogoo(floating hill), and miniature landscapes were called Chukjee(reduced land). Third, willows were planted on the outdoor yard, and plum trees were planted in front of the library, which led to bamboo woods road. Peony, camellia, tree peony and crepe myrtle were planted on the inner court with mossy rocks, small artificial hills, glass rocks, flower pots. There were rectangular ponds, while breeding deer, dove, rooster, and cranes. Fourth, landscape elements were enjoyed as metaphysical symbolic landscape by anthropomorphism, such as (1) gentlemen and loyalty, (2) wealth and prosperity, (3) Taoist hermit and poetical life, (4) reclusion and seclusion, (5) filial piety, virtue, introspection, etc. In other words, the garden presented a variety of gardening culture appreciating meaningful landscape, such as investigation of things, reclusion and seclusion, and building orientation of a fairyland yearning eternal youth and Mureungdowon(Taoist Arcadia) by making a garden blending beautiful flowers and trees, with precious birds and animals. Fifth, there were many landscape appreciation schemes, such as Angkyung(looking-up), Bukyung(looking-down), Jeokyung(looking-under), Chakyung(bringing outer space into inside), Yookyung(flower viewing), Yojeong(walking around the garden enjoying flowers), Hwasaekhyangbyuk(flower gardening), and Garden appreciation enjoying landscape through time and seasons with different inspirations.