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노인장기요양보험 수발등급 평가에 있어 노쇠지수 및 수정바델지수의 유용성
김원석,신형익 대한노인병학회 2008 Annals of geriatric medicine and research Vol.12 No.4
Background: There are no additional objective tools to double-check the care grades and to assess a subject's m edical status except a statem ent of the doctor's view in the assessm ent of care grades in geriatric long-term care service. Thus, w e designed this study to investigate w hether the frailty index (FI) and the K orean version of the m odified Barthel index (K-M BI) can be useful com plem entary assessm ent tools in the assessm ent of care grades in geriatric long-term care service. M ethods: Data for calculating care approved tim e, FI, and K-M BI were obtained from the interview of 114 hom eresidents (elderly >65 years of age) in S ungnam city by educated investigators. Results: There was a significant positive correlation between FI and care grade (Spearm an correlation coefficient = 0.547, p<0.001). A significant negative correlation between K-M BI and care grade (Spearm an correlation coefficient =-0.811, p<0.001) w as dem onstrated. The difference betw een the scores on the FI and K -M B I w as significant betw een the care grades (p<0.001). Conclusion: The FI and K-M BI had a good correlation with care approved tim e in geriatric long-term care service and were significantly different between the care grades. FI and K-M BI can be useful com plem entary assessm ent tools in the assessm ent of care grades in geriatric long-term care service.
이정은,신형익,도영경,양은주 대한의학회 2016 Journal of Korean medical science Vol.31 No.3
Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-ofpocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.
사지마비 환자에 대한 상지 재건술: 국내 실태와 활성화 방안
이상윤,신형익,공현식,빈성우,방문석 대한재활의학회 2008 Annals of Rehabilitation Medicine Vol.32 No.2
Objective: To know the present status of upper extremity reconstruction surgery for the person with tetraplegia in Korea and to suggest solutions to promote the procedures. Method: 62 physiatrists and 42 hand surgeons were surveyed with self administered questionnaire. The questionnaire was made up of 5 categories: (1) whether physicians had experienced these procedures in the past three years, (2) if they have had no experience, what the reasons were, (3) whether physicians desired to be involved in these procedures, (4) what the solution to promote these procedures should be, (5) the attitudes and beliefs of physicians about these procedures. The last category was analyzed by odds ratio between physicians who desired to be involved in the procedure and who didn't. Results: Only two physiatrists and six surgeons had experienced these procedures in the past three years. However many physicians desired to be involved in these procedures. The main reason of not performing these procedures was a lack of referral between physiatrists and surgeons. The physicians who desire to practice upper extremity reconstruction surgery or related rehabilitation had higher confidence on the benefits of the procedures and thought that they had knowledge and skills for the procedure. Conclusion: In spite of positive attitude to the upper extremity reconstruction for tetraplegic patients, few physicians have experienced in these procedures. This phenomenon was due to a lack of referral between physiatrists and surgeons. Advancing cross-specialty relationships and educating related physicians could be solutions to promote these procedures.
재가 중증 근위축성측삭경화증 환자 및 가족 돌봄제공자의 특성과 가족 돌봄제공자의 건강관련 삶의 질 관련성
김명수,신형익,민유선,김정윤,김정순 한국간호과학회 2011 Journal of Korean Academy of Nursing Vol.41 No.3
Purpose: The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers. Methods: The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis. Results: The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49±31.63 and 129.09±35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient’s gender, caregiver’s age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers. Conclusion: The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.