Herramientas de evaluación de actividades de la vida diaria instrumentales en población adulta: revisión sistemática / Tools for the evaluation of daily life activities instrumental in adults: systematic review

Introducción: La transición al modelo biopsicosocial implica que las herramientas de evaluación se adapten a esta nueva visión de la salud. Las herramientas usadas en Chile para medir la funcionalidad en las actividades de la vida diaria instrumentales (AVDI) son las mismas desde los años 50, por lo que se requiere hacer una revisión de la literatura a fin de conocer nuevas metodologías de evaluación en la materia. Objetivo: Identificar las herramientas de evaluación en AVDI, qué ítems son considerados, metodología de puntuación (rangos, puntajes, categorización de resultados), tiempo y contexto de aplicación, creadores de las herramientas y propiedades psicométricas de los mismos. Diseño: Revisión sistemática. Fuentes de datos: PubMed, BIREME y Epistemonikos. Se realizaron tres búsquedas: dos el 2018 (marzo y septiembre) y una el 2020 (diciembre). Selección de estudios: Estudios observacionales (estudios de cohorte y estudios de corte transversal) y revisiones sistemáticas que contemplaron la valoración de AVDI en mayores de 18 años, en inglés o español, publicados desde 1998 y de libre acceso. Extracción de datos: Se realizó lectura de títulos y resúmenes como primer filtro, y posteriormente el texto completo. Una vez seleccionados los estudios que cumplen con los criterios de inclusión, se les aplicó la pauta "Strengthening The Reporting of Observational studies in Epidemiology (STROBE)" y la pauta "Critical Appraisal Skills Programme Spanish (CASPe)" para evaluar la calidad metodológica. Se estableció, a través de un consenso de las investigadoras, que cada estudio seleccionado debía cumplir con al menos 13 de los 22 ítems de la pauta STROBE. Resultados: De los 27.606 artículos encontrados, 15 cumplieron con los criterios de inclusión y el punto de corte establecido de la pauta. Sólo un artículo era en idioma español y 14 en inglés; y fueron publicados principalmente en EE.UU. y España. De los 20 instrumentos encontrados en los artículos seleccionados, el 60% corresponde a la "Escala Lawton y Brody", el 10% a la de "The Performance Assessment of Self-Care Skills (PASS)" y el porcentaje restante otras herramientas. Conclusiones: A nivel internacional se han creado nuevas herramientas de evaluación de AVDI en respuesta a necesidades locales, dificultando la posibilidad de ser generalizadas a otros contextos sin contar previamente con un proceso de validación transcultural y estadística que resguarde la confiabilidad de su aplicación y data. La "Escala de Lawton y Brody", pese a las limitaciones ni sesgos, sigue siendo un patrón de oro a nivel internacional.

Background: The transition to the biopsychosocial model implies that the assessment tools are adapted to this new vision of health. In Chile, the evaluations to measure functionality on Instrumental Activities of Daily Living (IADL), have been the same since the 1950s, so a review of the literature is required to know new evaluation tools in the matter. Aim: To identify the evaluation tools that exist to assess the functionality in AVDI, what items are considered, scoring methodology (rank, score, categorization of results), time and in which contexts they are applied, assessment creators and psychometric properties. Design: Systematic review. Data sources: PubMed, BIREME and Epistemonikos. Three searches were carried out: two in 2018 (March and September) and one in 2020 (December). Study selection: Observational studies (cohort studies and cross-sectional studies) and Systematic Reviews that contemplated the assessment of IADL in people over 18 years of age, in English or Spanish, published since 1998 and open access. Data extraction: Titles and abstracts were read as a first filter, followed by the full text. Once the studies that met the inclusion criteria had been selected, the "Strengthening The Reporting of Observational studies in Epidemiology (STROBE)" and "Critical Appraisal Skills Programme Spanish (CASPe)" guideline was applied to assess methodological quality. It was established, through a consensus of the researchers, that each selected study had to comply with at least 13 of the 22 items of STROBE guideline. Results: Of the 27.606 articles found, 15 met the inclusion criteria and the established cut-off point of the guideline. One article was written in Spanish and 14 in English, which were carried out mainly in the United States and Spain (3 out of 15 respectively). Of the 20 instruments found in the selected articles, 60% correspond to "Lawton & Brody Scale", 10% to "The Performance Assessment of Self-Care Skills (PASS)" and the remaining percentage other tools. Conclusions: At an international level, new IADL assessment tools have been created in response to local needs, making it difficult to generalize to other contexts without previously having a cross-cultural and statistical validation process that safeguards the reliability of its application and data. The "Lawton s Brody Scale", despite its limitations and biases, remains an international gold standard.

Prevalence and determinants of Instrumental Activities of Daily Living (IADL) disability among communitydwelling elderly in a semi-urban setting in Peninsular Malaysia

@#Introduction: The ability to perform daily living activities among the elderly is important, as physical disability may lead to dependency and various public health implications. This study aimed to determine the prevalence of instrumental activities of daily living (IADL) disability and its association with socio-demographic characteristics, dietary intake, social participation, perceived-health-status and risk of falls. Methods: This cross-sectional study was conducted among communitybased elderly in the Gombak District of Selangor. 258 respondents aged 60-88 years old (mean age 66±6.5 years) were recruited through multi-stage proportional sampling. Most of the respondents (88.4%) aged 60-74 years and 11.6% were ≥75 years. IADL disability was determined using an eight-item IADL scale. The presence of IADL disability was defined as needing help in at least one or more of eight-IADL activities. Dietary intake and fall risk were assessed using diet history questionnaire (DHQ) and 21-item fall risk index (FRI-21), respectively. Results: The prevalence of IADL disability among the respondents was 58.1%. A binary logistic regression analyses showed that the following factors predicted IADL disability: advanced age (≥75 years, OR=6.4; 95% CI: 1.3, 30.8), being unmarried (OR=2.5; 95% CI: 1.1, 5.9), unemployed/retired (OR=2.3; 95% CI: 1.2, 4.3), and at risk of falls (OR=2.5; 95% CI: 1.3, 6.1). Conclusion: Predictors such as marriage and employment highlight the importance of social support among elderly. In practical terms, this means that it is incumbent upon caregivers, family members, and the community to provide both physical and emotional support if the functional status of the elderly is to be improved.

The interaction effect between physical and cultural leisure activities on the subsequent decline of instrumental ADL: the Fujiwara-kyo study

BACKGROUND@#Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown.@*METHODS@#We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index).@*RESULTS@#The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004).@*CONCLUSIONS@#We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.

Dental care utilization patterns by the status of ADL and IADL in the elderly / 대한구강보건학회지

OBJECTIVES: This study sought to analyze the effects of ADL and IADL on dental care utilization behaviors for the elderly 65 years of age and older. METHODS: Using data from the Korea Health Panel 2010-2011, we examined 2683 elderly people who did not use dental care and 12,550 cases of dental care utilization of 963 elderly people who used dental care among people aged 65 and older who responded to the items of ADL and IADL limitations. We employed two-part model (TPM) including logistic regression analysis in a first part of the model and negative binomial regression analysis in a second part of the model to estimate dental care utilization patterns associated with ADL and IADL of elderly adults. RESULTS: A frequency analysis revealed that dental care utilization was more frequent in the elderly with IADL limitations than in the elderly with ADL limitations. The first part of TPM predicted that dental care utilization was more likely to be present in males and younger age group along with increasing number of chronic diseases and independence in ADL and IADL. The results of the second part of TPM estimated the quantity of dental care utilization increased among high income groups. CONCLUSIONS: Limitations in ADL and IADL were found to affect the decision to seek dental care utilization, but physical limitations to have no statistical effect on the quantity of dental care utilization, once dental care utilization was taken for treatment. These findings suggested that dental care utilization would be determined by supplier induced demand and patient's own power to obtain treatment. Since decision to take dental care utilization, despite the barriers of limitations in activities, is an important factor which can satisfy medical needs, various policies to reflect oral health and physical fitness are required.

The assessment of the reason and type among disabled older Mongolians / Монголын Анагаах Ухаан

Introduction: Findings of study on disability types among Mongolian population confirm that 16631 (15.4) refers to visual impairment, speech and language disability 5999 (5.6), hard of hearing 12633 (11.7), mobility impairment 31265 (28.9), intellectual impairment 20898 (19.3) and other disabilities 20645 (19.1). There is no other study which assessed disability prevalence and some determinant factors which lead to disability and health status among older (ages women 55+, men 60+) disabled Mongolians. Goal: To assess the reason and type among disabled older Mongolians Materials and methods: This study was conducted on a random sample of disabled elderly people residing in Ulaanbaatar, Mongolia. Study is based on questionnaire and interview to indicate some health conditions. We used formal methods to assess activities of daily living and instrumental activities of daily living of disabled older people.Result: The sample represented 46.2% of men and 53.8% women in respondents. Median age of respondents was 75.2±10.5 (men 74.2±8.7, women 76.2±11.8). While 72.3% of respondents did physical work, 25.4% respondents did intellectual work and only 2.3% respondents had physical-intellectual work. According to the types of disability, 36.7% of respondents had mobility impairment, 16.7% of elder people had visual disability and 12.2% of respondents had hearing impairment. While 94.6% respondents had acquired disability, 4.6% respondents had congenital disability. In terms of activities of daily living, 76.2% of respondents had difficulty in bathing independently, 38.5% with dressing, and 62.3% had moving limitations at home.Conclusions:1. Mobility disability is higher (36.7%) than other types of disability among disabled older people.2. About 76.2% respondents had disability because of some diseases, about 8.5% about 8.5% from occupational disease, about 3.1% respondents from industrial injuries and about 11.5% respondents because of home injuries.3. Disability with activities of daily living is about 48% among disabled older people and the highest disabled daily activity is bathing, about 76.2%. Disability with instrumental activities of daily living is about 66% in disabled older people and the highest disabled instrumental activity is about 90%, is walking in long distance.4. According to this conclusion, disabled older people will greatly increase to demand health and social care assistance.

Analysis of the status and related factors of depression in elders in rural areas / 中华行为医学与脑科学杂志

ObjectiveTo observe the status and related factors of depression symptoms in elders.MethodsRandomized multi-stage sampling method was used to select subjects.504 elders ( aged ≥65 years) in Jining were investigated and assessed by using the scales of Geriatric Depression Scale15 ( GDS-15 ),Katz-activity of daily liying (Katz-ADL) and Lawton instrumental ADL (IADL).ResultsThe GDS scores of males (2.24 ±2.12 ) were significantly lower than that of females ( 3.35 ± 3.49) ( t '=4.236,P ＜ 0.01 ).There were significant differences in GDS scores among different subgroups of age,single or not,physical activity,sleep quality,self-reported health,living condition,economic status and lonely feeling.GDS scores were significantly correlated to lonely feeling,IADL,living condition,economic status,self-reported health and age (F =27.47,P ＜ 0.001 ; R2 =0.372,R'2 =0.358 ),with the total contribution of 35.8％.ConclusionAmong elders,the main factors influencing depression symptoms are lonely feeling,IADL,female,health condition,economic condition and single,respectively.Enhancing IADL of elders can contribute to reduce the risk factors of depression.

A Study about Elder Abuse Experiences of Elderly People / 재활간호학회지

PURPOSE: This study was to explore elderly people's elder abuse experiences, and the relations between the abuse experiences (direct and indirect) and their level of activities of daily living, family relations and self-integrity. METHOD: A descriptive survey was conducted, and the participants were 108 elderly people. Data were analyzed using SPSS by descriptive statistics and t-test. RESULT: It was that indirect abuse experiences of the elder was higher than direct abuse experiences. In this research, the most common kind of direct elder abuse was 'psychological abuse and negligence', and the severity was low. The largest portion of indirect abuse experiences belonged to 'physical abuse and negligence', and the severity was high. The older people who had direct abuse experiences showed lowered self-integrity and serious family problems and stress. CONCLUSION: The experiences of elder abuse showed differences in family relations and self integrity. Hence, there should be a nursing intervention improving psycho-social factors such as self integrity and family relations, and systematic and easily available supporting organizations for victims of elder abuse.

Restriction of Instrumental Activities of Daily Living in MCI / 신경정신의학

OBJECTIVES: Mild cognitive impairment (MCI) is distinguished from mild dementia by an absence of global intellectual deterioration and the preservation of activities of daily living (ADL). Recently, however, it became apparent that impairment of instrumental activities of daily living (IADL) is present before the threshold of dementia is reached. Thus, we want to examine whether IADL are impaired in patients with MCI, and which items of IADL are particularly involved. We divided the MCI group into amnestic (aMCI) and non-amnestic MCI (naMCI), and compared to the cognitively normal controls. In this study, we focused on the instrumental activities of daily living (IADL). METHODS: The sample consisted of 69 community-dwelling older adults from a welfare center for the aged in Korea. The subjects were divided into three diagnostic groups; aMCI [N=19, memory domains below -1.5 standard deviation (SD)], naMCI (N=19, other cognitive domains below -1.5 SD, except memory domains) and cognitive normal controls (N=31). Subjects were assessed both on IADL and the cognitive function. In order to assess the IADL, we used the Seoul -Instrumental Activities of Daily Living (S-IADL). Included measures of cognitive tests are as follows; Seoul Verbal Learning Test (SVLT), Rey Complex Figure Test (RCFT), Korean-Boston Naming Test (K-BNT), Stroop test, and Korean-Mini Mental Status Examination (K-MMSE). Groups were compared on the S-IADL and the cognitive tests. RESULTS: The three groups did not differ in the mean age, gender distribution and years of education. S-IADL were shown to be different between the groups in this study. Subjects with aMCI were significantly more impaired in S-IADL in comparison to the controls [F(2,50)= 4.251, p=0.020]. And on four items of S-IADL (shopping, transportation, medication and talking about recent events), subjects with aMCI showed higher impairment compared to the controls. However, the S-IADL did not differ between the subjects with naMCI and controls. CONCLUSION: In this study, impairment of S-IADL was shown in subjects with aMCI. And S-IADL of naMCI was not significantly differed from aMCI and controls. The results suggest that naMCI would be distinguished from aMCI in characteristics and prognosis.

Comparison of Instrumental Activities of Daily Living and Cognitive Functions Among the Elderly Attending Senior Community Centers According to the Presence of Depressive Symptoms / 신경정신의학

OBJECTIVES: The aim of this study was to evaluate whether or not depressive symptoms were related to differences in the abilities of daily living activities and cognitive functions among the elderly attending senior community centers. METHODS: A total of 304 respondents over 65 years of age completed a set of interviews, which included clinical evaluation, neuropsychological batteries, Short Geriatric Depression Scale (S-GDS), and Instrumental Activities of Daily Living (IADL). RESULTS: Depression was observed in 34.2% respondents (n=105). The depressed group significantly decreased the sum of IADL than that of the non-depressed group (t=3.8, p=0.0002). With logistic analysis, they indicated significant impairment in six items of IADL associated with cognitions, but not in other items with physical functions. The depressed group scored significantly lower in MMSE-K (F=8.56, p<0.01) and delayed recall assessment (F=10.53, p<0.01) despite they showed no difference in immediate memory, compared with the non-depressed group. Among the sociodemographic variables, gender was not a significant risk factor in the depressed elderly, whereas lower income was the only risk factor after adjusting for other variables. CONCLUSION: The depressed elderly attending senior community centers showed impaired functions in their usual daily activities and cognitions. Furthermore, they revealed impairment in cognitive IADLs, whereas they preserved functions in physical IADLs.

A Study on the Perceived Health Status, Depression, and Activities of Daily Living for the Elderly in Urban Areas / 여성건강간호학회지

PURPOSE: The study was done to identify the perceived health status, depression, and activities of daily living(ADL+IADL) of elderly women and men, and to define the difference between the two groups. In addition this study investigated the relationships among the variables of perceived health status, depression, and activities of daily living of both groups. METHOD: The subjects of this study were 579 elderly people over 65 years living in urban area. Data was collected through personal interviews using questionnaires from March to October 2005. Data was analyzed with the SPSS program. RESULT: There was a significant difference of perceived health status, depression, and activities of daily living(ADL+IADL) between the elderly women and men groups. There was a significant relationship among variables of perceived health status, depression, and activities of daily living in elderly men. However, there was no significant relationship among the variables in elderly women. CONCLUSION: The findings of this study give useful information for constructing an intervention program and care for elderly women and men.

The Effects of Multidimensional Program on Cognition, Physical Function and Depression for Institutionalized Elderly / 재활간호학회지

PURPOSE: This study was conducted to examine the effect of multidimensional program on cognition, physical function and depression among institutionalized elderly and the relationship between study variables and resident's characteristics and health related variables. METHOD: This study involved a one group pre and post test, comparison of variables over a 12 month period. To investigate this research question, data of 114 residents of a nursing home were analyzed. RESULTS: There was statistically significant difference in MMSE-K (t=-2.63, p=.010), ADL (t=-2.85, p=.005), and depression (t=4.66, p=.000) before and after program participation. CONCLUSION: These results indicate that, for a year their regular involvement in a broad spectrum of multidimensional program activities can improve in cognitive, physical and emotional perspectives, but the level of IADL decreased significantly (t=-6.72, p=.000). Further testing is required with the control group, to compare with community resident elders in order to explore the effects on social skill of elderly.

Effects of Logotherapy with Exercise on Meaning of Life, Ego Integrity and IADL in the Elderly / 간호학회지

PURPOSE: The purpose of this study was to examine the effects of 'Logotherapy with Exercise' on the meaning of life, ego integrity and IADL's in the Elderly. METHOD: This quasi-experimental study was designed for a nonequivalent control group repeated measurement study. This study was done from Oct. 13. 2004 to Dec. 18. 2004. The subjects were between the ages of 65 to 75, who were literate in Korean and able to communicate and participate in physical exercise without any discomfort. The experimental group was 25 subjects and the control group was 26. The 5-week 'Logotherapy with Exercise' program was given to the experimental group. Data was analyzed by chi-square, t-test, ANCOVA, ANOVA, and post-hoc comparison by Bonferroni correction with the SPSS/WIN 12.0. RESULTS: The experimental group had a greater difference in meaning of life, ego integrity and IADL's than the control group. The experimental group had differences in changes in meaning of life, ego integrity and IADL's during time period. CONCLUSION: 'Logotherapy with Exercise' can be recommended as an effective nursing intervention for the elderly.

The Effects of Exercise Program for the Elderly

No abstract available.

Quality of life and the related Factors in Cerebrovascular Surgery Patients / 재활간호학회지

PURPOSE: The purpose of this study was to investigate the quality of life and related factors of CVA surgery patients. METHOD: The subjects were 64 CVA surgery patients who had discharged and received follow up care at the OPD. Data were collected using William's SS-QOL instrument and IADL. And Data were analyzed with SPSS WIN program in which frequency, percentage, t-test, Pearson's correlation and stepwise regression were used to examine the quality of life and related factors. RESULT: General characteristics related to QOL were marital status and economical status. Depression was the most important factor with influence on QOL in CVA disease patients after surgery. There were further positive correlation between patient's IADL and QOL and between patient's social support and QOL. Meanwhile the patient's depression level was negatively correlated with QOL. CONCLUSION: Depression was the most important factor with influence on QOL in CVA patients after surgery. Therefore active nursing intervention to decrease depression and to improve patient's physical functional status in needed. And the patient's family should be included in all nursing intervention and patient education so that the patient's quality of life is prompted by the maintenance of optimal wellbeing.

Physical Health Status, Depression and Activities of Daily Living of the Low-income Elderly Living Alone in Metropolitan Areas

PURPOSE: This study was conducted to investigate physical health status. depression. activities of daily living (ADL & IADL) of the low-income elderly who live alone in urban areas. METHOD: The subjects were the 400 low-income elders who live alone in Daegu city and the following instruments were used: 1. The number of self-reported physical health problems and present diseases: 2. CES-D scale for depression by Jo Nam-Oak et al. (1998): and 3. ADL scale by Katz (1989) and IADL scale by Lawton and Brody (1969). RESULTS: 1. Visual difficulty was the most prevailing problem (55.3%) among physical problems. the second bowel elimination and the third hearing disturbance. As for present diseases. arthritis (26.5%), hypertension(24.3%) and DM (11.8%) were the most common diseases. 2. There were significant differences in physical health status according to age (t=3.115. p=.045). kind of medical security (t=-1.973. p=.049). perceived life satisfaction (F=4.966. p=.007) and the number of present diseases (F=2.937. p=.033). 3. There were significant differences in depression according to sex (t=-3.758. p=.000) . kind of medical security (t=-4.368. p=.000). perceived life satisfaction (F=35.743. p=.000) and the number of present diseases (F=4.246. p=.006). 4. There were significant differences in ADL according to sex (t=-2.136. p=.033) and age (F=4.863. p=.008). and in IADL according to sex (t=4.552, p=.000), age (F=3.090. p=.047) and kind of medical security (t=-3.306. p=.001). 5. Physical health state was correlated positively with both the number of present diseases (r=.140. p=.005) and depression (r=.352. p=.000), and negatively with ADL (r=-.176. p=.000) and IADL (r=-.230. p=.000). Depression was correlated positively with the number of present diseases (r=.169. p=.001) and negatively with both ADL (r=-.139. p=.005) and IADL (r=-.203. p=.000). CONCLUSION: The results of this study suggest that general characteristics are important factors for physical health status, depression. ADL and IADL of the low-income elderly who live alone and there are close relations among physical health status, the number of diseases, depression, ADL and IADL. Therefore, these results must be reflected in community health programs for the low-income elderly who live alone. In addition, this kind of study must be extended to the low-income elderly who live alone in rural areas.

Correlational Study of IADL, Self-Esteem, Empowerment of Elderly People Living at Home / 기본간호학회지

PURPOSE: The purpose of this study was investigate the relationship between IADL, self-esteem and empowerment of elderly home residents. METHOD: The data were collected from Aug. 1st to September 30, 2004. The participants were 274 elderly people who lived at home. Data were collected using structured questionnaire and analysed using the SPSS program. RESULT: Mean scores for IADL, self-esteem and empowerment were 3.74, 3.22, 3.36 respectively. IADL and self-esteem showed a significantly positive correlation to empowerment. CONCLUSION: This results indicate that the elderly people need more self-esteem and empowerment. Therefor it is important to develop effective strategies to enhance empowerment in elderly people.

A Study on the Reliability and Validity of Seoul-Instrumental Activities of Daily Living(S-IADL) / 신경정신의학

OBJECTIVES: Seoul-Instrumental Activities of Daily Living (S-IADL) was developed to assess elderly person's instrumental everyday activities. This study aims to develop standardized IADL assessment scale and to confirm the reliability and validity of the S-IADL. METHODS: The 336 controls were included in standardization study. Reliability and validity of S-IADL were tested by 72 Alzheimer's disease patients and 72 controls matched to age, sex, and education. We also conducted Receiver Operating Characteristics curve for sensitivity and specificity of S-IADL. RESULTS: Because of positively skewed distribution of S-IADL, standardization data were presented using 1SD and 2SD value. Internal consistency, test-retest reliability, and interrater reliability were statistically significant. Principal axis factoring analysis revealed two factors that accounted for 59.95% of the total variance, and second factor was items sensitive to sex (3.preparing food/cooking, 4.household chores). S-IADL was correlated significantly with other standardized cognitive measures, demonstrating good convergent validity. With a cut-off point of 8, the S-IADL had a sensitivity of 83.3% and specificity of 93.1% in the diagnosis of dementia. Also, with a 2SD standardized data, sensitivity was 81.9% and specificity was 93.1%. CONCLUSION: Our study showed that the S-IADL could be a reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-IADL had higher sensitivity and specificity than other IADL instruments, suggesting that it is useful to early detection of dementia.

Trends & Evaluation of K-ADL in Sorokdo / 나학회지

Background : Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale were developed to measure the function of the old. The evaluation through K-ADL and K-IADL is important for the optimal medical service to the disabled old people on the Sorokdo. This study was conducted to assess the functional disability of them and to find out the suitable medical service. Method : This research was collected from 731 Sorokdo residents in Oct, 2003. The data were compared by chi-square test, independent t-test and ANOVA test using SPSS(ver 10.0) with alpha-error=0.05. Result : Bathing-points and clothing-points on ADL scale are comparatively low: points of the women lower than those of the men; the group over 65 years than group under that age; the patients who have combined disease than the patients who have not; and the patients who have been hospitalized more than once than those who have not been. Besides, the points of the not-disabled are lower than those of disability, the lower one`s points on ADL scale. It is due to the fact that there are many not-disabled persons over 65 years old. Preparing-a-meal points and washing-points on IADL scale are comparatively low: points of the women lower than those of the men; the group over 65 years than group under that age; the patients who have combined disease than the patients who have not; the patients who have been hospitalized than those who have not been one a more; and the seriously- disabled and the slightly-disabled. The points on Barthel ADL scale are dwindling annually by 0.3 to 0.5, the decrease of the women being greater than that of the men. Conclusion : Special medical programs for the old patients and a rehabilitation health service will improve the reliability of medical service on Sorokdo hospital and increase quality of life.

The Effects of Koryo Hand-Acupuncture on the Patients with Chronic Low Back Pain / 간호학회지

PURPOSE: The purpose of this study was to identify the effects of Koryo Hand-Acupuncture on health status(pain, trunk flexion, IADL, depression) of patients with chronic low back pain. METHOD: This study used a quasi experimental pre-test and post-test design. Data were collected from December 1st, 2000 to December 20th, 2001. 63 chronic low back pain patients(35 experimental group, 28 control group) admitted to the Back-School and consented to this study. The experimental group participated in treatment : Koryo Hand-Acupuncture and AB-Bong. Two groups was homogeneity. After 4 weeks the effects of treatment on the health status was measured between experimental and control group. Data were analyzed using SPSSWIN 10.0 with crosstab, t-test, and paired t-test. RESULT: In the experimental group, pain(t=4.85, p=.000) and IADL difficulty(t=2.05, p=.045) was significantly lower than those in the control group. It makes no difference trunk flexion(t=-1.60, p=.114) and depression(t=1.50, p=.138) between experimental and control group. CONCLUSION: These findings indicate that Koryo-Hand Acupuncture is an effective method for reducing pain and IADL difficulty in patients with chronic low back pain, and is considered as a independent nursing intervention for chronic low back pain.

Study of Adult Stroke Patients and Improvement in Activities of Daily Living from Time of Stroke to Two Months Thereafter

BACKGROUNDS: A stroke is a disease of the nervous system which is accompanied by important chronic disabilities and emotional disorders. These disabilities causes loss of sensation(diminished basic movement). METHODS: Sensation rehabilitation therapy through Activities of Daily Living(ADL) Training is necessary. Reports show that patients who receive occupational therapy in the early stages have an extremely high rate of recovery in the early stages. It is important for a occupational therapist to provide continued reha- bilitative treatment to, enable the patient to accomplish Activities of Daily Living Training independently by treating everything from sustaining posture in bed to normal movement and improvement in sensory perception. occupational therapy refers to the `use of self` of a occupational therapist to help the patient overcome difficulties and increase abilities of the patients by applying knowledge, skill, care and basic patient merits. RESULTS: A occupational therapist must have the basic knowledge, self-confidence and individual skills for a systematic program of therapy in order to be able to communicate with the patient and increase the effectiveness of the therapy. CONCLUSION: This study showed that therapy for patients who received therapy soon after diagnosis of stroke showed to be greatly effective. A deeper study must be done in order to increase effectiveness of occupational therapy methods such as the NDT(treatment to improve normal movement sensation) and SI method(treatment to increase sensitivity of perceptive movement and to give the ability to position objects according to shape and location).