Swallowing in Patients with Mental Disability - Analysis of 189 Swallowing Video Endoscopies

Abstract Introduction Feeding, swallowing and breathing are fundamental activities for the survival and well-being of humans; these functions are performed by themost complex neuromuscular unit of the human body, which, when altered, may raise morbidity and mortality rates. Objective To evaluate deglutition in patients with mental disability in order to determine the incidence and the severity of dysphagia. Methods A total of 189 institutionalized adult patients with mental disability were analyzed using a 3.2 mm flexible fiberscope (Machida, Japan 1995). The following food consistencies were tested: pasty, thickened liquid and liquid. Results Among the total of 189 patients, 101 (53.4%) were female aged between 14 and 55 years old. Most of them 120 (63.5%) had profound mental deficiency, 58 (30.7%) had severe mental deficiency, 9 (4.8%) had moderate mental deficiency, and 2 (1.1%) had mild mental deficiency. Gender and the degree of mental deficiency did not influence significantly the degree of dysphagia. Age, degree of disability and interaction between age groups and degrees of disability influenced significantly the degree of dysphagia. Younger patients are more likely to present more severe dysphagia. Stabilization occurs between 31 and 40 years of age, and above this age, a greater chance of less severe dysphagia, because the increase in the degree of mental deficiency decreases the probability of more severe dysphagia. Conclusion The population that mostly presented severe dysphagia was characterized by being mostly female, with profound mental deficiency, with an average age of 36.7 years. There was no relationship between gender and the degree of mental disability concerning the degree of dysphagia. (AU)

Impact of personal rehabilitation treatment on life quality and curative effect of schizophrenia patients / 中国基层医药

Objective@#To explore the impact of the personal rehabilitation treatment on life quality and curative offect of the schizophrenia patients.@*Methods@#A total of 84 patients with chronic schizophrenia in Shanxi Rongjun Corelle Hospital from December 2016 January 2018 were randomly divided into intervention group and control group on the basis of random number table, the two groups received psychiatric routine therapy nursing and general entertainment therapy, and the intervention group received 8 weeks of individualized rehabilitation therapy on this basis.The Schizophrenics Quality of Life Scale(SQLS) and Positive and Negative Symptoms Scale(PANSS) were respectively used to evaluate the effect of the two groups before and after intervention.@*Results@#After 8 weeks of systematic social skills training, the scores of negative symptoms, general psychopathology and total PANSS score in the intervention group were (14.65±3.68)points, (24.21±3.23)points, (52.83±7.12)points, respectively, which in the control group were (21.82±4.25)points, (28.08±4.56)points, (60.67±9.52)points, respectively, the differences between the two groups were statistically significant(t=5.18, 3.35, 3.92, all P<0.01), while the positive symptom score had no statistically significant difference between the two gorups (P>0.05). The PANSS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention (t=2.17, 5.98, 3.86, 4.13, all P<0.05). After the intervention training, the psychosocial score, motivation and energy score, symptoms and adverse reactions score, and total score of SQLS in the intervention group were (32.64±7.32)points, (39.45±10.87)points, (18.16±10.48)points, (90.34±24.17)points, which in the control group were (35.32±10.64)points, (43.82±12.43)points, (21.05±11.52)points, (98.25±32.29)points, respectively, and the differences between the two groups were statistically significant (t=2.46, 3.51, 3.12, 3.96, all P<0.05). The SQLS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention(t=3.94, 4.72, 3.87, 5.01, all P<0.01).@*Conclusion@#The personal rehabilitation treatment can greatly promote the curative offect of patients with chronic schizophrenia, improve their life qualities.

Impact of personal rehabilitation treatment on life quality and curative effect of schizophrenia patients / 中国基层医药

Objective To explore the impact of the personal rehabilitation treatment on life quality and curative offect of the schizophrenia patients.Methods A total of 84 patients with chronic schizophrenia in Shanxi Rongjun Corelle Hospital from December 2016 January 2018 were randomly divided into intervention group and control group on the basis of random number table,the two groups received psychiatric routine therapy nursing and general entertainment therapy,and the intervention group received 8 weeks of individualized rehabilitation therapy on this basis.The Schizophrenics Quality of Life Scale (SQLS) and Positive and Negative Symptoms Scale (PANSS) were respectively used to evaluate the effect of the two groups before and after intervention.Results After 8 weeks of systematic social skills training,the scores of negative symptoms,general psychopathology and total PANSS score in the intervention group were (14.65 ± 3.68) points,(24.21 ± 3.23) points,(52.83 ± 7.12) points,respectively,which in the control group were (21.82 ± 4.25) points,(28.08 ± 4.56) points,(60.67 ± 9.52) points,respectively,the differences between the two groups were statistically significant(t =5.18,3.35,3.92,all P ＜0.01),while the positive symptom score had no statistically significant difference between the two gorups (P ＞ 0.05).The PANSS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention (t =2.17,5.98,3.86,4.13,all P ＜ 0.05).After the intervention training,the psychosocial score,motivation and energy score,symptoms and adverse reactions score,and total score of SQLS in the intervention group were (32.64 ±7.32)points,(39.45 ± 10.87) points,(18.16 ± 10.48) points,(90.34 ± 24.17) points,which in the control group were (35.32 ±10.64) points,(43.82 ± 12.43) points,(21.05 ± 11.52) points,(98.25 ± 32.29) points,respectively,and the differences between the two groups were statistically significant (t =2.46,3.51,3.12,3.96,all P ＜ 0.05).The SQLS scores and total score in the intervention group after intervention had statistically significant differences compared with those before intervention (t =3.94,4.72,3.87,5.01,all P ＜ 0.01).Conclusion The personal rehabilitationtreatment can greatly promote the curative offect of patients with chronic schizophrenia,improve their life qualities.

Significance of Support Groups for Parents of Mentally Disabled Children in Their 20s / 日本プライマリ・ケア連合学会誌

Introduction: This study examined the significance of support groups from the perspective of families for members who were parents of mentally disabled children in their 20s.Methods: We conducted semi-structured interviews with parents who joined support groups for families of mentally disabled young adults. A qualitative and inductive classification method was used to extract categories from the data obtained.Results: Five parents agreed to participate in an interview survey. Ten categories were identified: "talking to others in the same situation", "pleasant places where they feel at ease", "connecting with other families", "sharing the same issues with others", "talking about things other than their children", "learning from each other", "promoting empowerment as a parent", "dealing with their children more easily", "improving family relationships", and "preparation for raising issues within the community".Conclusion: Parents who joined support groups for families of mentally disabled young adults felt that it was important to share problems regarding their children's siblings, the types of housing their children are faced with living in when they become independent, and the types of insurance plans their children can purchase. They also found it important for family support groups to be able to help prepare them to raise issues within the community.

Deficiência: uma heurística para a condição humana / Disability: a heuristic for the human condition / Discapacidad: una heurística para la condición humana

Resumen Estudio de naturaleza teórica donde se evidencia la discapacidad como dispositivo heurístico para indagar la condición humana. La relación entre discapacidad y condición humana ha sido poco explorada. En la primera sección se analiza cómo vulnerabilidad y dependencia pertenecen a la condición humana e inciden en la discapacidad condicionando la pérdida de cualidades. Posteriormente se analiza la modalidad peculiar de posesión de las mismas. En la tercera parte se argumenta cómo a pesar de que con la discapacidad intelectual puede no manifestarse la racionalidad esto no supone una exclusión de la condición personal. Por último, se explica cómo no obstante con la discapacidad se puedan perder cualidades, no es posible perder la corporeidad y la pertenencia a la familia humana. Se empleó el enfoque heurístico con la formulación de preguntas apoyándose en tres casos hipotéticos. La discapacidad es un modo de manifestarse de la condición humana con valor heurístico porque ayuda a examinar aspectos constitutivos de nuestra existencia.

Abstract A theoretical study in which disability is evidenced as a heuristic device to investigate the human condition. The relationship between disability and human condition has been little explored. The first section analyzes how vulnerability and dependence belong to the human condition and affect disability by conditioning the loss of qualities. Subsequently, the peculiar modality of possession of our qualities is analyzed. The third part argues that even though a human being with intellectual disability may not manifest rationality this does not suppose an exclusion of the status of person. Finally, it is explained how, although qualities can be lost with the disability, it is not possible to lose the embodiment and belonging to the human family. The heuristic approach was used with the formulation of questions based on three hypothetical cases. Disability is a manifestation of the human condition. It has heuristic value because it helps to examine constitutive aspects of our existence.

Resumo Estudo teórico em que a deficiência é evidenciada como dispositivo heurístico para sondar a condição humana. A relação entre deficiência e condição humana tem sido pouco explorada. A primeira seção analisa como vulnerabilidade e dependência pertencem à condição humana e afetam a deficiência, condicionando a perda de qualidades. Posteriormente, a ideia de posse de nossas qualidades é analisada. Na terceira parte se argumenta que, embora um ser humano com deficiência intelectual não possa manifestar racionalidade, isso não supõe a exclusão do status pessoal. Por último, se explica como, apesar de ser possível perderem-se qualidades na deficiência, não é possível perder a corporeidade e o pertencimento à família humana. A abordagem heurística foi utilizada com a formulação de questões com base em três casos hipotéticos. A deficiência é uma manifestação da condição humana e tem valor heurístico porque ajuda a examinar aspectos constitutivos de nossa existência.

Biochemical and hematological evaluation in subjects with intellectual disability associated or not to Down syndrome / Avaliação bioquímica e hematológica em indivíduos com deficiência intelectual associada ou não à síndrome de Down

ABSTRACT Down syndrome (DS) is one of the most leading causes of intellectual disability. The aim of this study was to compare biochemical and hematological parameters, triglyceride/high-density lipoprotein cholesterol (HDL-C) and neutrophil/lymphocyte ratios in individuals with intellectual disabilities (ID) associated or not with DS. The main result is the lower HDL-C level in individuals with DS than in the ID group, suggesting a modification in the lipid profile whose origin would lie in genetic alterations. However, further researches are important to analyze if there is any link between trisomy 21 and the reduction of plasma HDL-C levels in individuals with DS.

RESUMO A síndrome de Down (SD) é uma das principais causas de deficiência intelectual. Os objetivos deste estudo foram comparar parâmetros bioquímicos e hematológicos, bem como encontrar a relação triglicerídeo/colesterol da lipoproteína de alta densidade (HDL-C) e a razão neutrófilo/linfócito em indivíduos com deficiência intelectual (DI) associada ou não à SD. O principal resultado foi a diminuição do HDL-C em indivíduos com SD quando comparados àqueles com DI, sugerindo que essa modificação no perfil lipídico pode se relacionar com alterações genéticas. Portanto, pesquisas adicionais são importantes para analisar se existe ligação entre a trissomia 21 e a redução dos níveis de HDL-C em indivíduos com SD.

Lived Experience of Primary Caregivers of People with Mental Disability / 정신간호학회지

PURPOSE: This phenomenological study was done to explore in-depth understanding of the lived experience of primary caregivers of people with mental illness. METHODS: Participants were 7 primary caregivers and data were collected from November 2017 to February 2018. Giorgi's phenomenological method was used in this study. The caregiving experiences were categorized into separate types of situational structures in terms of specific and general descriptions. RESULTS: Six clusters and fourteen sub-clusters were identified. The 6 clusters were found to be ‘Embarrassing encounter with a disease’, ‘Sustained regret and self-defeating’, ‘Family life of constant oppression’, ‘Confinement of a mental illness’, ‘Nagging label of mental illness’, and ‘Recognizing the disease as a fate and taking courage’. CONCLUSION: The study findings emphasize the importance of both local and national support and the provision of information designed for primary caregivers of people with mental disability. Psychiatric nurses should understand and consider the growing number of increasing social prejudices, stigma, and caregiver burden so as to improve interpersonal relationships brought about by mental illness.

Overcoming Internalized Stigma in Persons with Psychiatric Disabilities / 정신간호학회지

PURPOSE: This phenomenological study was done to identify comprehensively and in depth the experience of overcoming internalized stigma in persons with psychiatric disabilities. METHODS: Data were collected from December 2015 to June 2016 with 10 persons who had psychiatric disabilities. The participants took part in interviews on their experiences of overcoming stigma. The collected data were analyzed using Colaizzi method. RESULTS: From the raw data obtained from the study participants, 12 themes and 5 theme clusters were identified. The 5 theme clusters were found to be ‘being locked up in one's own stigma’, ‘trying to escape from the self in constraints’, ‘overcoming oneself by oneself’, ‘getting to see the true self’, and ‘living the life desired’. CONCLUSION: Study findings indicate the necessity of developing a mediation program to reduce and overcome the internalized stigma in the persons with psychiatric disabilities. A national and social effort is necessary for persons with psychiatric disabilities to help them overcome the internalized stigma.

Experience of Maintaining Employment for Mentally Disabled People: Q Methodological Approach / 정신간호학회지

PURPOSE: The purpose of this study was to identify characteristics of the experience of maintaining employment for people with mental disabilities. METHODS: The research design was a descriptive design using Q-methodology, which is a method of measuring subjectivity. Twenty-one participants classified 34 selected Q-statements on a nine-point scale to create a normal distribution. The PC-QUANL software program(a factor analysis program for the Q technique) was used to analyze the Q-sort data. RESULTS: Three types were extracted that described different expressions of the experience of maintaining employment for people with mental disabilities; these types explained 52.3% of the total variance. Type I is ‘Workplace support’, Type II is ‘Self-management’, Type III is ‘Experience integration’. CONCLUSION: The results of this study provide an understanding that there are different types of experiences for maintaining employment for people with mental disabilities and each type has certain characteristics. In future studies, it would be helpful to develop customized nursing interventions for psychiatric nurses while occupational rehabilitation services are being provided.

Evolutionary Concept Analysis of Resilience in People with Mental Disabilities / 정신간호학회지

PURPOSE: This study was done to define and clarify the concept of resilience in people who are mentally disabled. METHODS: Rodgers' evolutionary approach to concept analysis was used to identify common attributes, antecedents, and consequences of the resilience of people who have mental disabilities. A literature search of the RISS, Kiss, CINAHL, PubMed, ProQuest, Scopus and PsycArticle databases from 1980 to 2016 was conducted, using the key words of ‘psychiatric disorder resilience’, and ‘mental illness resilience.’ Thirteen relevant articles and one book were finally selected and reviewed in depth. RESULTS: The concept analysis showed that, the attributes of resilience in people with mental disabilities were ‘flexibility’, ‘potentiality’, ‘strengthening’. The antecedents of resilience were psychiatric symptoms and perceived stigma. The consequences of resilience were understood to be recovery. CONCLUSION: The findings in this study indicate that it is important to provide preliminary knowledge necessary for mental health nurses to reinforce resilience in people with mental disabilities. There is also a need to develop a scale to measure resilience in this population.

Effect of Pilates Gymball Exercises on the Electroencephalogram and Cognitive Function in Mentally Disabled Persons

PURPOSE: The aim of this study was to determine if Pilates gymball exercise can change the electroencephalogram and cognitive function of mentally disabled people. METHODS: Twenty-one mentally disabled people were enrolled in this study. They were assigned randomly to one of two groups: Pilates gymball exercise group (PGEG, n=11), and control group (CG, n=10). The subjects in the PGEG group performed the exercises for 50 minutes a day, three days per week for 6 weeks. The PGEG program consisted of warm up (10 minutes), main workout (30 minutes), and cool down (10 minutes). The main workout consisted of 10 exercise programs. The electroencephalogram (EEG) of Fp1, Fp2, F3, F4, C3, C4, O1, and O2 were measured using an PolyG-I system. The cognitive function was evaluated using a mini-mental state examination (MMSE). The measurements were performed before exercise, and 6 weeks after exercise. Covariance analysis (ANCOVA) was performed to determine the difference between the two groups. RESULTS: A significant difference in Fp1, Fp2, and F3 on the relative alpha power was observed between the PGEG and CG groups (p < 0.05). A significant difference in Fp1 on the relative beta power was observed between the PGEG and CG groups (p < 0.05). No significant difference in the MMSE score was observed between the PGEG and CG groups. CONCLUSION: Pilates gymball exercise did positively change the EEG in the frontal lobe. On the other hand, the effect related to cognitive was limited. Pilates gymball exercise appears to be more effective in facilitating brain stimulation related to cognition.

The Research About Guarantee of Life Existence for the Mentally Disabled in Our Country---Based Ethical and Legal Perspectives / 中国医学伦理学

This paper analyzed the current survival status of mentally disabled person:hard family living condi-tions, lack of equal employment opportunity, and in isolation for a long time. Based on the perspective of law and ethics, it puts forward to strengthen the legislative work, establish and improve the supervision mechanism, perfect the judicial procedure of right remedy for mentally disabled in the view of legal. It should be guided by the ethical thought, set up ethical morality that respect, concern, care for the mentally disabled, construct barrier-free humanity environment, and realize a series of measures that the mentally disabled could participate in society in the view of ethics, to further improve the environment for the mentally disabled, to maintain their legitimate rights and interests, and to safeguard the realization of life value and social value for the mentally disabled.

Concept Analysis of Motivation for Vocational Rehabilitation in Persons with Mental Disabilities / 정신간호학회지

PURPOSE: This study was conducted to analyze and clarify the concept of 'motivation for vocational rehabilitation in persons with mental disabilities'. METHODS: A hybrid model was used to analyze the concept of motivation for vocational rehabilitation in persons with mental disabilities. The model included a comprehensive literature review and field study. Field study was conducted through in-depth interviews with 5 persons with mental disabilities who had employment experience and participant observation in rehabilitation facilities. RESULTS: The concept of motivation for vocational rehabilitation in persons with mental disabilities was found to be a complex phenomenon having meaning in two dimensions: Goal-oriented and cognitive dimensions. Five attributes and fourteen indicators were defined. Motivation for vocational rehabilitation in these persons was defined as a recognition of the need to get a job, and the willingness and confidence to get and keep a job in order to achieve normal life, happiness, economic stability, and their value. CONCLUSION: The findings from this study will contribute to the development of assessment tools and nursing interventions to reinforce the motivation for vocational rehabilitation in persons with mental disabilities.

Nutrient and Carotenoid Intakes and Dietary Habits in Mentally Disabled Adults / 대한지역사회영양학회지

OBJECTIVES: According to preceding studies, many people with mental disability have unbalanced dietary habits or excessive intake of calories. Most of them are overweight or obese due to lack of self-control for food consumption, swallowing with inadequate chewing and physical inactivity. Therefore, this study aimed to assess the nutritional intake, including carotenoid, in mentally disabled people and find out a possible solution for nutritional improvement. METHODS: People with intellectual disability (N=28), emotional disability (N=44) participated in this study. The disorder grades were from I to III and ages were between 20 and 65 years. Assessments included anthropometry, daily intake of nutrients, including carotenoid, ROMA III questionnaire for assessing bowel movement. RESULTS: The average BMI of intellectually disabled people and emotionally disabled people was in the range of overweight and obesity respectively (23.7 +/- 6.3 kg/m2, 25.8 +/- 4.1 kg/m2). Overall, the frequencies of vegetable and dairy product intakes were lower in this population. When compared with Recommended Nutrient Intake (RNI) from Dietary Reference Intakes for Koreans 2010, the intakes of vitamin B1, vitamin B2 and calcium were insufficient in both groups. Also, lycopene intakes of carotenoid were low, compared with traditional Korean diet of the non-disabled people from the second year 2008 of the 4th National Health and Nutrition Survey. In addition, emotionally disabled people also had lower intake of cryptoxanthin. CONCLUSIONS: The mentally disabled people in this study showed lower intakes of vitamin B1, vitamin B2, calcium and carotenoids. Based on these findings, we recommend that it is important to encourage mentally disabled people to consume sufficient amounts of such nutrients in order to promote nutritional status.

Sujeitos deficientes intelectuais: o papel da linguagem na dinâmica familiar / Intellectual disability subjects: the role of language in family dynamics / Sujetos con discapacidad intelectual: el papel del lenguaje en la dinámica familiar

Objetivo: desenvolver a compreensão sobre o papel da linguagem de deficientes intelectuais na dinâmica de suas famílias. Método: trata-se de uma pesquisa qualitativa de caráter retrospectivo observacional em que foram analisados relatos obtidos no contexto do grupo terapêutico fonoaudiológico. Foram realizadas transcrições de gravações, em vídeo, de encontros dos grupos terapêuticos de pais de deficientes intelectuais. Foram selecionados para análise relatos colhidos em três reuniões, nas quais os pais falaram sobre a linguagem de seus filhos. As categorias de análise selecionadas para o presente estudo foram: interesse das mães sobre a linguagem; dificuldade de compreender os filhos; dificuldade de ser compreendida pelos filhos; e, estigmatização. Resultados: verificou-se, por meio da análise dos resultados, que a linguagem é um tema de grande interesse das famílias, inclusive porque as características da linguagem desses sujeitos contribuem fortemente para sua estigmatização. Observou-se, também, que a forma como os pais se posicionam quanto à linguagem de seus filhos relaciona-se ao modo como se estabelecem as relações familiares, com consequências diretas para o desenvolvimento do sujeito deficiente. Conclusões: a troca de experiências entre participantes do grupo favoreceu a (re)significação de seus anseios, e da visão a respeito das potencialidades de seus filhos. Os pais reconheceram o papel essencial da linguagem como função social, bem como sua importância para a compreensão entre pais e filhos. A estigmatização do sujeito com deficiência esteve presente em todas as categorias de análise, o que sugere que as reuniões devam ser constantes, favorecendo as trocas e (re)significações.

Objective: develop the comprehension of the role of language of intellectually disabled subjects in their family dynamics. Methods: this is a qualitative retrospective observational study, where there were analyzed the reports obtained in the context of a speech therapy group. There were carried transcriptions of video recordings of meetings of therapeutic groups for parents of intellectually disabled subjects. There were selected for analysis the accounts collected in three meetings, in which parents talked about their children?s language. The categories of analysis selected for this study were: the interest of mothers on language, the difficulty of understanding the children, the difficulty of being understood by children, and stigmatization. Results: it was found, by analyzing the results, that language is a topic of great interest for families, also because the language characteristics of these subjects strongly contribute to the stigmatization of them. It was also observed that the way parents are positioned in respect to their children language is related to how family relationships are established, with direct consequences for the development of persons with disability. Conclusion: the exchange of experiences among the group participants favored the (re)signification of their wishes, and of the vision of the potential of their children. Parents recognized the essential role of language as a social function, as well as its importance for the understanding between parents and children. The stigmatization of the subject with disability was present in all categories of analysis, suggesting that the meetings should be constant, encouraging exchanges and (re)significations.

Objetivo: desarrollar la comprensión sobre el papel del lenguaje de discapacitados intelectuales en la dinámica de sus familias. Método: se trata de investigación cualitativa de caracter retrospectivo observacional en que se analizaron informes obtenidos en el contexto de un grupo terapéutico fonoaudiológico. Se realizaron transcripciones de grabaciones, en videos, de reuniones de grupos terapéuticos para los padres de discapacitados intelectuales. Se seleccionaron para el análisis informes cojidos en tres sesiones, en las que los padres hablaron sobre el lenguaje de sus hijos. Las categorías de análisis seleccionadas para este estudio fueron: interés de las madres sobre lenguaje; dificultad de comprensión de los niños, dificultad de ser entendida por los niños; y estigmatización. Resultados: se encontró, mediante el análisis de los resultados, que el lenguaje es un tema de gran interés de las familias, entre otras razones porque las características del lenguaje de estos sujetos contribuyen fuertemente para su estigmatización. Se observó también que la manera como los padres se posicionan a respeto del lenguaje de sus hijos está relacionado al modo como las relaciones familiares se establecen, con consecuencias directas para el desarrollo de la persona con discapacidad. Conclusión: el intercambio de experiencias entre los participantes de los grupos favoreció la (re)significación de sus deseos, y de la visión a respeto del potencial de sus hijos. Los padres reconocieron el papel esencial del lenguaje como función social, así como su importancia para el entendimiento entre padres e hijos. La estigmatización del sujeto con una discapacidad estuvo presente en todas las categorías de análisis, lo que sugiere que las sesiones deben ser constantes, para favorecer los intercambios y (re)significaciones.

Modeling of Recovery Profiles in Mentally Disabled and Intact Patients after Sevoflurane Anesthesia; A Pharmacodynamic Analysis

PURPOSE: Mentally disabled patients show different recovery profiles compared to normal patients after general anesthesia. However, the relationship of dose-recovery profiles of mentally disabled patients has never been compared to that of normal patients. MATERIALS AND METHODS: Twenty patients (10 mentally disabled patients and 10 mentally intact patients) scheduled to dental surgery under general anesthesia was recruited. Sevoflurane was administered to maintain anesthesia during dental treatment. At the end of the surgery, sevoflurane was discontinued. End-tidal sevoflurane and recovery of consciousness (ROC) were recorded after sevoflurane discontinuation. The pharmacodynamic relation between the probability of ROC and end-tidal sevoflurane concentration was analyzed using NONMEM software (version VII). RESULTS: End-tidal sevoflurane concentration associated with 50% probability of ROC (C50) and gamma value were lower in the mentally disabled patients (C50=0.37 vol %, gamma=16.5 in mentally intact patients, C50=0.19 vol %, gamma=4.58 in mentally disabled patients). Mentality was a significant covariate of C50 for ROC and gamma value to pharmacodynamic model. CONCLUSION: A sigmoid Emanx model explains the pharmacodynamic relationship between end-tidal sevoflurane concentration and ROC. Mentally disabled patients may recover slower from anesthesia at lower sevoflurane concentration at ROC an compared to normal patients.

Factors Affecting Turnover Intention of People with Mentally Disabilities Working in Manufacturing Industry / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify turnover intentions in workers with mentally disabilities working in manufacturing industry. METHODS: Participants were 147 workers with mentally disabled living in B-city and Y-city. The data were collected from September 1st to November 30th, 2011 using self-report questionnaires including measurements of turnover intentions, family support, work volition, working environment, job satisfaction and internalized stigma. Data analysis was done using the SPSS/WIN 18.0 program. RESULTS: The average score for turnover intention was 2.9+/-0.7. Turnover intention was related to job satisfaction, working environment, family support and internalized stigma. The predicting factors for turnover intention were job satisfaction, internalized stigma and gender. Those factors accounted for 41.9% of turnover intention. CONCLUSION: The results imply that workers with mentally disabled need to reduce internalized stigma as well as to increase job satisfaction in order to decrease turnover intention.

Social cognitive performance and different communication settings in groups of children with different disorders / Desempenho sócio-cognitivo e diferentes situações comunicativas em grupos de crianças com diagnósticos distintos

PURPOSE: To investigate the social-cognitive performance of children with diagnostics of autism spectrum disorder (ASD), mental disability (MD) and hearing impairment (HI) in two different communicative situations. METHODS: Participated in this study 30 children ages between 3 and 12 years starting speech language therapy processes, divided in three groups: Group 1 - ten children with diagnoses included in the Autism Spectrum Disorders (ASD); Group 2: ten children diagnosed with mental disabilities (MD) and Group 3: ten children diagnosed with hearing impairment (HI). The subjects were assessed in two different communicative situations (group and individual therapy situation) for 12 months. RESULTS: Data regarding the performance of the three groups in the two situations show that G3 had better absolute performance when compared with other groups, with the variable symbolic play as an important differential criterion for the three groups. CONCLUSION: We conclude that the social-cognitive performance can be used as an auxiliary tool for intervention, helping the identification of variables that could interfere in the communicative performance.

OBJETIVO: Verificar o desempenho sócio-cognitivo de crianças com diagnósticos inseridos nos distúrbios do espectro do autismo (DEA), deficiência mental (DM) e deficiência auditiva (DA) em duas diferentes situações comunicativas. MÉTODOS: Participaram desta pesquisa 30 crianças, entre 3 e 12 anos de idade, em início de atendimento fonoaudiológico, que foram divididas em três grupos: Grupo 1: dez crianças com diagnóstico inserido nos distúrbios do espectro do autismo (DEA); Grupo 2: dez crianças com diagnóstico de deficiência mental (DM); Grupo 3: dez crianças com diagnóstico dentro do grupo de deficiência auditiva (DA). Os sujeitos foram analisados em duas situações comunicativas distintas (situação em grupo e situação individual de terapia), durante 12 meses. RESULTADOS: O grupo composto por crianças e adolescentes com diagnóstico de deficiência auditiva apresentou melhor desempenho absoluto quando comparado com os outros grupos, sendo a variável jogo simbólico um importante critério diferencial nos três grupos. CONCLUSÃO: O desempenho sócio-cognitivo pode ser utilizado como instrumento auxiliar no planejamento terapêutico, facilitando a identificação de variáveis que possam interferir no desempenho comunicativo.

Proactivity of People with Mental Disabilities: Concept Analysis / 정신간호학회지

PURPOSE: This study was conducted to investigate the clear concept of proactivity of people with mental disabilities and to provide basic evidence for mental health nursing. METHODS: The research was conducted using Walker & Avant's conceptual analysis process. RESULTS: Proactivity of people with mental disabilities is defined as the ability of obtaining self-determination by putting continuous efforts toward their recovery, overcoming social stigma, recovering in a positive way from being withdrawn from relationships, and gaining self-confidence and willingness that they can recover from their mental illness. Antecedents were found to be persistent disease management, active participation and support of significant person. Consequences were found to be maintenance of a productive life. CONCLUSION: The results of this study accurately define the vague concept of proactivity of people with mental disabilities and contribute to mental health nursing related to proactivity for people with mental disabilities.

Associated Factors of Job Satisfaction on Part-time Work of the Mentally Disabled / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the degree of satisfaction of part-time work of the mentally disabled and the factors affecting their job satisfaction. METHODS: The subjects of this study were 106 part-time workers with mental illness in the city of B and Y. The data were collected from February 1, 2012 to May 30, 2012 using self-report questionnaires including the measurement scales of job satisfaction, family support, work volition and the degree of satisfaction with work environment. The data were analyzed using t-test, ANOVA, Pearson correlation coefficients, multiple regression with the SPSS/WIN 18.0 program. RESULTS: The mean of score for job satisfaction was 61.8+/-13.84. Job satisfaction was highly related to family support, work environment and work volition. The associated factor of the subjects job satisfaction were family support, work environment, work volition, and the period of employment. The combination of these four factors showed an explanation for job satisfaction at the rate of 80.2%. CONCLUSION: The results imply that job satisfaction needs to be increased for the job continuity of employees with mental illness. In addition to this, work environment, work volition and family support should first be improved for the increase of job satisfaction.