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To investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis of Korean Longitudinal Study of Ageing (KLoSA) dataset.
A retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed with stroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modeling to develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatory factor analysis with a one-factor model. Item-level psychometric analysis of the ADL instrument included fit statistics, internal consistency, precision, and the item difficulty hierarchy.
The study sample included a total of 201 community-dwelling adults (1.5% of the Korean population with an age over 45 years; mean age=70.0 years, SD=9.7) having a history of stroke. The ADL instrument demonstrated unidimensional construct. Two misfit items, money management (mean square [MnSq]=1.56, standardized Z-statistics [ZSTD]=2.3) and phone use (MnSq=1.78, ZSTD=2.3) were removed from the analysis. The remaining 15 items demonstrated good item fit, high internal consistency (person reliability=0.91), and good precision (person strata=3.48). The instrument precisely estimated person measures within a wide range of theta (−4.75 logits < θ < 3.97 logits) and a reliability of 0.9, with a conceptual hierarchy of item difficulty.
The findings indicate that the 15 ADL items met Rasch expectations of unidimensionality and demonstrated good psychometric properties. It is proposed that the validated ADL instrument can be used as a primary outcome measure for assessing longitudinal disability trajectories in the Korean adult population and can be employed for comparative analysis of international disability across national aging studies.
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To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF).
The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues.
Sixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators.
Numerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation.
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To identify the validity and reliability of the Korean version World Health Organization Quality of Life Assessment (WHOQOL)-BREF among people with physical impairments living in a community.
Participants listed in the community-based rehabilitation project were recruited from 45 public health centers. People with brain lesions or physical disabilities were selected. Respondents (n=750) filled out the Korean WHOQOL-BREF questionnaire. Obtained data were analyzed statistically to assess the internal consistency as well as the construct and discriminant validity. An exploratory factor analysis was also performed.
Cronbach's α for the total score was 0.839. The value for each domain ranged from 0.746 to 0.849. Pearson correlation coefficient between each domain ranged from 0.539 to 0.717. The highest correlation was between the psychological and physical domain. The item-domain correlation indicated a significant correlation with their original domains. A multiple regression analysis of each domain with two overall questions was performed. The psychological domain made the strongest contribution with the overall quality of life (unstandardized coefficient B=0.065, r2=0.437). When general health satisfaction was considered as a dependent variable, the physical domain most strongly contributed to the variable (unstandardized coefficient B=0.081, r2=0.462). Exploratory factor analysis yielded four factors in the WHOQOL-BREF, accounting for 55.29% of the variability. To assess the discriminant validity, a comparison of each domain with Modified Barthel Index (MBI) was conducted. There were highly significant changes across the MBI scores with the WHOQOL-BREF domains (p<0.001).
Korean WHOQOL-BREF is a valid and reliable tool to measure the quality of life for people with physical impairments. It has good internal consistency, construct validity and discriminant validity for the population. Further study with a stratified sample is needed.
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Objective: The purposes of this study were to investigate the factors influencing life satisfaction and quality of life (QOL) of the disabled persons and to help the planning and evaluation of Community Based Rehabilitation (CBR).
Method: Data were collected through personal interviews of 503 registrated disabled persons in Uiwang City. Demographic variables and scores of modified Barthel index (MBI), modified Lambeth disability screening questionnaire (MLDSQ), Craig handicap assessment and reporting technique (CHART) and life domain satisfaction measure (LDSM) were obtained.
Results: The score of LDSM was 4.0⁑1.0. Life satisfaction was related to the age, sex, employment status, severity of disability, educational level, housing and residence, level of instrumental activities of daily living and social integration. MLDSQ score was the most strong predictor of life satisfaction (p=0.00) followed by social integration (p=0.001) and total CHART scores (p=0.017). And the factors influencing the handicap were monthly income, severity of disability, employment, level of education and age.
Conclusion: Based on our study, we suggest that the CBR program of Uiwang City need to focus on improving functional ability and social skill of disabled individual and housing, and also promoting their vocational and educational status. (J Korean Acad Rehab Med 2002; 26: 615-625)
Objective: To investigate the status and basic demand of community based stroke-disabled for rehabilitation program development in an urban area.
Method: The subjects were 46 residencial stroke disabled over 6 months after disease onset. Two teams (composed of one physiatrist and one nurse, respectively) visited patient's home, and evaluated physical and functional status and surveyed for the status and basic demand of community based rehabilitation.
Results: Forty two patients (91.3%) received primary medical care after onset of the stroke, and twenty two patients (47.8%) received rehabilitation therapy. The most common reason for not having received rehabilitation therapy was poor economic state. University hospital was the most common place of their rehabilitative management. Mean score of Modified Barthel Index (MBI) was 60.7. Mean score of Craig Handicap Assessment and Reporting Technique (CHART) was 223 and economic self-sufficiency scale presented the lowest score as 6.5⁑4.6. The desire of patients for rehabilitation and welfare service was rehabilitation management and the desire of subjects for the government and society was warrant for livelihood.
Conclusion: We concluded that rehabilitation program utilizing common resource such as areal university rehabilitation team and facilities of community health center should be developed. (J Korean Acad Rehab Med 2002; 26: 254-267)
Objective: To collect the informations of the traumatic spinal cord injury persons in Suwon city.
Method: Seventy-five traumatic spinal cord injury persons were evaluated by the neurological level, American Spinal Injury Association scale, Functional Independence Measure (FIM), Craig Handicap Assessment and Reporting Technique (CHART), Beck Depression Inventory (BDI), and questionnaire on their voiding methods, complications, etc.
Results: The leading cause of 75 persons with traumatic spinal cord injury was a traffic accident. Among them, paraplegics were 46 persons. The most common complication was a pressure sore which was also the leading cause of their rehospitalization. Twenty-six persons voided by reflex. Among five dimensions of CHART, the physical independence score was the highest and the economic self sufficiency score was the lowest. The total CHART scores were significantly correlated with BDI scores, FIM scores, and level of injury.
Conclusion: This study revealed that physical impairment, disability and depression affect the handicaps of spinal cord injury persons. These data could be used to develop a social rehabilitation program for the spinal cord injury persons in the community.
Objective: To compare key-person method with census method on the prevalence of physically disabled students and to obtain the prevalence of the physically disabled students in rural community.
Method: Total 4,890 students of 20 schools in Kyungaido province were surveyed in 1997. Two-thousands and twenty-two students of 8 schools were surveyed by a census method and 2,868 students of 12 schools by a key-person method.
Results: The prevalence of the physically disabled students in rural community was 0.53% of the population. The prevalence of the physically disabled students was 0.69% by a census method and 0.42% by a key-person method. This result suggests that there is no significant difference in the prevalence of physically disabled students between the two survey methods (p＞0.05).
Conclusion: A key-person method is as effective as a census method for prevalence survey of physically disabled students in rural communities because of cost effectiveness and less personnel.
Objective: Aims of this study are to assess the activities of daily living (ADL) for disabled persons in some rural communities using an appropriately developed ADL scale and to analyse the relationship between severity of impairment and ADL score.
Method: ADLs of 98 disabled persons in two myeons of Kyunggido were assessed from May 1996 to August 1997. The newly developed ADL index composed of eight basic ADL (B-ADL) and two instrumental ADL (I-ADL) parameters were used. Impairment defined by the National Reparation Law was divided into a severely disabled group, grades 1 to 6 and a mildly disabled group, graded 7 to 14. Correlations between the impairment grade of each body part and the assessed ADL score were studied.
Results: 1) The most dependent ADL item of ten ADL parameters was performance in the public office (37.8%) and, the most independent ADL item was feeding (98.0%). 2) With severe impairment of the upper or lower limb, all ADL scores except for feeding were significantly low (p＜0.05). In addition, with severe hearing impairment, scores of performance in public office were accessed low (p＜0.05). 3)With severe lower limb impairment, average scores of I-ADL and B-ADL were low (p＜0.05). 4) With severe language impairment, the average I-ADL score was also low (p＜0.05).
Conclusion: The task of performance in the public office was the most difficult ADL item for disabled persons. All ADL parameters except feeding were affected for disabled persons with lower or upper limb impairment. We think this pilot study may be used to develop more appropriate ADL scales for community based rehabilitation in the future.
Objective: To compare the efficiency of a key-person method with the census method on the prevalence of physically disabled.
Method: The residents of K-myeon, A-kyun, Kyungido were surveyed in May 1996 with a census method and of D-myeon in August 1997 with a key-person method. The enlisted people in this survey included 2563 persons in D-myeon and 2138 persons in K-myeon on Identification Number.
Results: The prevalences of the physically disabled were 2.61% of the population in D-myeon and 5.00% in K-myeon (chi-square test: P＜0.500). When the physically disabled were divided into two groups (the severely disabled, group A and the mildly disabled, group B), the prevalences of group A was 1.91% in D-myeon and 2.15% in K-myeon (chi-square test: P＞0.500). This result suggests that there is no meaningful difference in the prevalence of severely disabled between the two survey methods.
Conclusion: The key-person method is as effective as the census method to survey the prevalence of severely disabled in rural communities and requires a less cost and man power.
The purpose of this study were to obtain the prevalence of the physically disabled order as a basic data for the planning of Community-Based Rehabilitation in a rural community and to evaluate the seventy of the physically disabled by according to the physical disability grade.
The total residents in the community were surveyed to in May 1996. The prevalence of the physically disabled was 6.92% of the total population. The male: female ratio was 1:0.7. The most freguent age for the on set of physical disability was sixties and this group represented 35.5% of all physical disabilities. The majority of the physically disabled was graded an 10 th, 11 th, 12 th grade.
The prevalence of the physically disabled in this study was higher than that a the previous study due to the inclurion of more mild disability groups were important in the prevalence of the physically disabled.
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