일 지역 성인의 호스피스 인식과 사전의료의향서에 대한 지식과 태도의 관계

박경란,장선희 대한통합의학회 2019 대한통합의학회지 Vol.7 No.4

본 연구는 일 지역 성인의 호스피스 인식과 사전의료의향서에 대한 지식 및 태도를 파악하기 위한 서술적 상관관계 조사연구이다. 연구대상은 경상남도 C시에 거주하는 일반 성인이 221명을 대상으로 2018년 7월 5일부터 7월 15일까지 설문 조사를 실시하였으며, 210명을 최종자료로 분석하였다. 대상자의 호스피스 인식 정도는 4점 만점에 평균은 3.05점이었고, 사전의료의향서에 대한 지식은 9점 만점에 평균 7.49점이었으며, 사전의료의향서에 대한 태도는 4점 만점에 평균은 2.82점이었다. 대상자의 일반적 특성에 따른 호스피스 인식 정도는 경제적 수준, 종교의 중요성, 호스피스에 대해 들어 봄, 사전의료의향서에 대해 들어 봄, 사전의료의향서 작성의향에 따라 유의한 차이가 있었다. 대상자의 일반적 특성에 따른 사전의료의향서에 대한 지식 정도는 연령, 입원경험, 종교, 집안에 문제가 생겼을 때 최종 결정자, 사전의료의향서 작성의향에 따라 유의한 차이가 있었다. 대상자의 일반적 특성에 따른 사전의료의향서에 대한 태도는 결혼상태, 사전의료의향서 작성의향에 따라 유의한 차이가 있었다. 상관관계에 있어서는 호스피스 인식과 사전의료의향서에 대한 태도( =.47, p<.001), 사전의료의향서에 대한 지식과 태도 간에( =.20, p=.005) 유의한 양의 상관관계가 있었다. 이상의 결과를 종합해 볼 때, 호스피스 인식과 사전의료의향서 태도는 양적 상관이 있음이 확인되어 호스피스 인식과 사전의료의향서에 대한 지속적인 교육 및 범국민적 공감대를 활성화하는 것이 필요할 것이다. Purpose : This narrative research study aimed to identify the degree of correlation between hospice awareness and knowledge of and attitude toward advance directives. Methods : A survey was conducted from July 5 to July 15, 2018 with 210 adults in ​​C city, Gyeongsangnam-do. Using the SPSS 21.0 program, the data analysis methods utilized were the independent t-test, one-way ANOVA, Scheffe, and Pearson's correlation coefficients. Results : The degree of hospice awareness was measured according to the general characteristics of the subjects, which were as follows: heard about economic level, importance of religion, heard of hospice, heard about advance directives, and intention to execute advance directives. The knowledge of advance directives had significant differences by age, hospitalization experience, religion, and being the final decision maker for a family problem. The attitude toward advance directives differed significantly by marriage status and the intention to write an advance directives. The relationship between hospice awareness and knowledge and attitude toward advance directives showed a positive significant correlation (r=.47, p<001). The relationship between knowledge of and attitude toward advance directives also indicated a positive significant correlation (r=.20, p=.005). Conclusion : This study provided basic data to inform promotion of hospice awareness and an educational intervention about advance directives.

디지털감각지각훈련프로그램이 발달장애 아동의 손기능과 시각-운동 통합 능력에 미치는 영향

김고운,오혜원 대한통합의학회 2019 대한통합의학회지 Vol.7 No.4

목적 : 본 연구는 발달장애 아동 30명을 대상으로 디지털감각지각훈련프로그램을 제공하지 않은 그룹과 발달장애 아동의 손 기능 및 시각 운동 통합 능력에 미치는 영향을 구분하였다. 방법 : 8주 동안 총 16회, 1주일에 2회 50분씩 실험군과 대조군 각 20명으로 나누어 실시하였다. 젭센-테일러 손 기능 테스트는 개입 전후의 손 기능을 알아내기 위해 사용되었으며, 비주얼 모터 통합 기능을 식별하기 위해 Beery VMI-6을 수행하였다. 결과 : 중재 후 실험군에서 손기능 및 시각 운동 통합 능력은 현저하게 증가하였으나 통제군에서는 현저하게 증가하지 않았다. 이는 디지털 감각 훈련 프로그램에서 발달장애 아동의 손 기능 및 시각적 운동 통합에 긍정적인 영향을 미쳤다. 결론 : 따라서, 디지털 감각 인식 훈련 프로그램은 발달 장애 아동의 손 기능과 시각적 운동 통합 능력을 긍정적인 중재 방법임을 보여주었다. Purpose : This study examined the hand function and visual motor integration capabilities in 30 children with developmental disabilities. The children were divided into an experimental group (n = 20) that received digital sensory perception training and a control group (n = 10) that did not receive this training. Methods : Training was conducted a total of 12 times for six weeks, for 50 minutes a day, twice a week, for the experimental group. The Jebsen-Taylor Hand Function Test was used to determine the hand function before and after the intervention, and the Beery VMI-6 was performed to identify the visual motor integration capability. Results :After the intervention, the ability to perform hand functions and visual motor interaction increased significantly in the experimental group but not in the control group. Digital sensory training therefore had a positive effect on the hand function and visual motor integration in children with developmental disabilities. Conclusion : A digital sensory perception training program is an arbitration method that can positively improve the hand function and visual motor integration ability in children with developmental disabilities.

tDCS를 결합한 고강도 인터벌 훈련이 축구선수의 유산소 운동능력에 미치는 영향

양대중 ( Dae-jung Yang ),엄요한 ( Yo-han Uhm ) 대한통합의학회 2021 대한통합의학회지 Vol.9 No.4

Purpose : This study examined the effect of transcranial direct current stimulation (tDCS) combined high intensity interval training (HIIT) on the aerobic exercise capacity of college soccer players. Methods : The subjects of this study were 30 college soccer players. They were divided into a high intensity interval training group combining transcranial direct current stimulation (Group I) and a high intensity interval training group (Group II). Each group had 15 subjects randomly assigned. After receiving general soccer training, each group additionally received high intensity interval training combined with transcranial direct current stimulation and high intensity interval training for 30 minutes 5 times a week for 8 weeks. Their VO2max and 20 meter shuttle run test, Yo-Yo intermittent recovery test were analyzed before the intervention. After 8 weeks of intervention, the above items were re-measured and an intergroup analysis was performed. Results : As a result of comparative analysis of VO2max intake between groups, 20 meter shuttle run test and Yo-Yo intermittent recovery test, a statistically significant difference was found. The high intensity interval training group (Group I) combined with transcranial direct current stimulation showed a significant difference in aerobic exercise capacity compared to the high intensity interval training group (Group II). Conclusion : These results showed that high intensity interval training group combined with transcranial direct current stimulation was more effective for aerobic exercise. Based on this study, this study proposes an effective program for patients as well as elite athletes. In the future, it is necessary to develop an effective transcranial direct current stimulation program and to study how to apply it for various patients.

재활치료와 관련된 사람들의 작업치료에 대한 인식조사

정명진 ( Myeong Jin Jung ),장철 ( Chel Jang ) 대한통합의학회 2013 대한통합의학회지 Vol.1 No.2

Purpose : This study was to investigate the awareness on occupational therapy by the people involved in rehabilitation of persons with disabilities Methods : The survey on the awareness of occupational therapy was conducted on 9 organizations and 111 employees associated with rehabilitation, of which the collected data was calculated in percentage using the results Result : 89.2% answered with "I know the subject of occupational therapy," 66.6% with "I know the meaning of it," 81.1% with "I know the purpose of it," being awared that it has been conducted in medical institutions and other places. However those answers might need more precise information for each occasion. In addition, for the distinction between occupational therapy and other kinds(physical therapy, speech therapy, art therapy, play therapy, music therapy), 40.5% answered with "yes in some degree," but 19% with "no." Regarding the eligibility requirement for occupational therapist, 55% answered with "qualified with a licence." Conclusion : Active promotion will be required more focusing on the subject of occupational therapy, the meaning of occupation, the purpose and working places of occupational therapy, the difference from other therapies, and the qualification of occupational therapist.

대사질환자의 모려 온열요법이 대사질환 관련 변인과 면역 및 호흡건강 관련 변인에 미치는 영향

신재숙,김충곤,박장준,배원식,최희정,김원경,손원준,김준혁,이화경,김현준 대한통합의학회 2022 대한통합의학회지 Vol.10 No.4

Purpose : In this study, using Oyster Shell Thermal Therapy for metabolic diseases, we analyzed the effect of immune and inflammation-related variables and respiratory health-related variables of test subjects to verify the effect of improving respiratory health. Methods : In this study, 26 patients with metabolic diseases were divided into an experimental group (N=13) and a control group (N=13). After Oyster Shell Thermal Therapy (four weeks/three times a week/1 hour per time), metabolic disease-related variables and immune and respiratory health-related variables were measured and compared between the two groups. The conclusion of this study is as follows: Results : After the four-week Oyster Shell Thermal Therapy, in terms of changes in the metabolic disease-related variables, the control group exhibited a higher increase in TC and LDL-C levels than the experimental group. In the case of glucose, the experimental group showed a decrease after the experiment (p<.05). After the four-week thermotherapy, a statistically significant interactive effect occurred in natural killer (NK) cells among the immune-related variables. According to the results of a post-experimental analysis, the control group showed a higher decrease in NK cells than the experimental group (p<.05). After the 4-weeks thermotherapy, the experimental group showed a greater increase in maximum oxygen intake of the respiratory health-related variables than the control group. Conclusion : Based on a comprehensive review of the study results, the subjects who underwent the four-week Oyster Shell Thermal Therapy exhibited positive physical changes in metabolic disease-related variables as well as immune and respiratory health-related variables, which demonstrates the effectiveness of Oyster Shell Thermal Therapy on immune and respiratory health. Accordingly, it is recommended to conduct long-term Oyster Shell Thermal Therapy with various models in terms of the size and shape.

PNF 목 굽힘 운동과 Curl-up 운동이 만성 뇌졸중 환자의 배근육의 활성도와 몸통 조절 및 균형에 미치는 효과 비교

김경돈,김현수 대한통합의학회 2020 대한통합의학회지 Vol.8 No.4

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients’ trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects’ muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects’ trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study’s results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients’ abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

대학생들의 긴장성 두통 유무에 따른 스마트폰 중독, 전방 머리 자세, 삶의 질, 두통 영향 및 두통 장애 지수 비교

김치환 ( Kim Chihwan ),이동건 ( Lee Donggeon ) 대한통합의학회 2020 대한통합의학회지 Vol.8 No.4

Purpose : VDT (visual display terminal syndrome) can affect individuals who monitor or who work or play using video screens, including those of smartphones. In general, headache symptoms from overuse of these screens can appear due to eye fatigue, muscle pain in the joints of wrists or fingers, and muscle pain in the neck or shoulders. Many studies in the literature have supported standards that seek to prevent these symptoms. The incidence of musculoskeletal diseases caused by the use of smartphones is expected to increase rapidly, particularly among children and young adults, and these diseases are expected to develop into a societal problem. Therefore, in this study we investigate whether tension headaches that develop from smartphone usage can affect forward neck posture, neck pain, and quality of life. Methods : A total of 93 students from University participated in this study. We divided participants into two groups, those with tension headaches (n = 25) and those without (n = 68) and took forward neck measurements. Headaches were classified according to criteria from the International Headache Society and involved bilateral headache position, quality of pressing or tightening pain, mild or moderate pain intensity, and none due to daily physical activity. We surveyed participants using the smartphone addiction diagnosis questionnaire, the Neck Disability Index (NDI), the Headache Impact Test (HIT-6), and the Quality of Life Questionnaire. Results : Although we found no significant differences in tension headaches due to smartphone addiction diagnosis (p = 0.25), SF-36 life quality assessment (p = 0.06), and cranio-vertebral angle (p = 0.07), we found significant differences from the HIT-6 and the NDI (p <.05). Conclusion : Tension headaches are not correlated with smartphone addiction, quality of life, and forward neck angle but do have a correlation with the degree of cervical dysfunction and the effects of the headaches.

외부 환경 변화에 의한 비 접촉 체온계의 오차 범위 측정

김정은 ( Kim Jeongeun ),박상웅 ( Park Sangwoong ),최혜경 ( Choi Heakyung ) 대한통합의학회 2020 대한통합의학회지 Vol.8 No.4

Purpose : A person infected by SARS-CoV2 may present various symptoms such as fever, pain in lower respiratory tract, and pneumonia. Measuring body temperature is a simple method to screen patients. However, changes in the surrounding environment may cause errors in infrared measurement. Hence, a non-contact thermometer controls this error by setting a correction value, but it is difficult to correct it for all environments. Therefore, we investigate device error values according to changes in the surrounding environment (temperature and humidity) and propose guidelines for reliable patient detection. Methods : For this study, the temperature was measured using three types of non-contact thermometers. For accurate temperature measurement, we used a water bath kept at a constant temperature. During temperature measurement, we ensured that the temperature and humidity were maintained using a thermo-hygrometer. The conditions of the surrounding environment were changed by an air conditioner, humidifier, warmer, and dehumidifier. Results : The temperature of the water bath was measured using a non-contact thermometer kept at various distances ranging from 3~10 ㎝. The value measured by the non-contact thermometer was then verified using a mercury thermometer, and the difference between the measured temperatures was compared. It was observed that at normal surrounding temperature (24 ℃), there was no difference between the values when the non-contact thermometer was kept at 3 ㎝. However, as the distance of the non-contact thermometer was increased from the water bath, the recorded temperature was significantly different compared with that of mercury thermometer. Moreover, temperature measurements were conducted at different surrounding temperatures and the results obtained significantly varied from when the thermometer was kept at 3 ㎝. Additionally, it was observed that the effect on temperature decreases with an increase in humidity Conclusion : In conclusion, non-contact thermometers are lower in lower temperature and dry weather in winter.

지지면에 따른 마비 측 한 발 서기 훈련이 만성 편마비 환자의 보행속도와 균형에 미치는 효과

김명철 ( Kim Myungchul ),이홍준 ( Lee Hongjun ) 대한통합의학회 2020 대한통합의학회지 Vol.8 No.3

Purpose: This study aimed to investigate the effect of single-leg stance training according to different support surfaces on walking speed and balance in patients with chronic hemiplegia. Methods: Twenty-two patients with chronic stroke were randomly categorized into an experimental group (11 patients) and a control group (11 patients). In the experimental group, single-leg stance training was performed on an unstable surface after 50 min of general physical therapy. In the control group, single-leg stance training was performed on a stable surface after 50 min of general physical therapy. All participants performed five sets of single-leg stance exercises per minute and rested for 3 min. The intervention was performed 5 times a week for 4 weeks, and each patient was evaluated using the Berg Balance Scale (BBS), Fugl-Meyer Assessment Scale (FMA), and difference in walking speed between the first and last day of the intervention. Results: Compared to baseline measurements, both study groups showed significant increases in FMA, BBS, and walking speed (p< .05) after the intervention. However, there was no statistically significant difference (p >.05) between the experimental and control groups. However, in the experimental group, the increases in FMA, BBS, and walking speed were 3.36 %, 9.50 %, and 7.71 %, respectively. In the control group, the increases in FMA, BBS, and walking speed were 2.39 %, 6.65 %, and 7.64 %. Conclusion: Single-leg stance training on different support surfaces could help improve walking ability and balance in patients with chronic hemiplegia

가상현실 기반의 링 피트 어드벤처 코어 운동이 배가로근, 배속빗근, 배바깥빗근의 두께에 미치는 영향

윤삼원,윤성영,박한규 대한통합의학회 2022 대한통합의학회지 Vol.10 No.4

Purpose : The purpose of this study was to analyze the change in thickness of transvers abdominis, internal oblique, and external oblique when virtual reality based ring fit adventure is applied to young adults in order to investigate the effect of ring fit adventure on core stabilization. Methods : 30 subjects participated in the experiment. Subjects were randomly assigned to two groups. 15 subjects performed ring fit adventure core exercise (experimental group) and 15 subjects bridge and dead bug exercise (control group). The ring fit adventure core exercise program consists of 6 types, 1) bow pull, 2) overhead lunge twist, 3) pendulum bend, 4) seated ring raise, 5) plank, 6) warrior III pose. Each exercise was performed for 5 minutes, for a total of 30 minutes. The bridege and dead bug exercise were performed for 15 minutes each for a total of 30 minutes. All interventions were performed 3 times a week for 4 weeks. Thickness of the abdominal muscles was measured with a ultrasound. The paired t-test was used to compare the thickness of the transverse abdominis, internal oblique, and external oblique before and after intervention, and the comparison between groups was analyzed using the independent t-test. Results : As a result, in the experimental group, thickness of transverse abdominis and internal oblique increased significantly (p<.05), but external oblique decreased significantly (p<.05), and in the control group, thickness of transverse abdominis, internal oblique, and external oblique increased significantly (p<.05). There was a significant difference in external oblique in the difference between groups (p<.05). Conclusion : These study results showed that core exercise using ring fit adventure can reduce external oblique and increased selective muscle activity of transverse abdominis and internal oblique of the deep abdominal muscles, so it is meaningful as an effective intervention for core stabilization.