Areas Of Self-care Research Articles

How Gender Affects Students with Behavioral Disabilities

When should “deviant” behavior not actually be considered deviant? When it's the result of messages sent by the environment and social institutions. For some, it's a legitimate reaction to frustration with society's messages and the environment that contributes to it. This is especially true of students with emotional and behavioral disabilities (EBDs). “All behavior happens in context,” said Dr. John Palladino, a key consideration when dealing with students with these disabilities. All schools have seen a rise of students with emotional and behavioral disabilities. Advances in pharmaceuticals and cognitive behavioral therapy have enabled affected students to enroll in college in increasing numbers, bringing new and unforeseen challenges to the classroom and the campus. Like all students, those with EBDs interpret their environments and their gendered messages. But EBD students can experience those environments and settings in ways that may contribute to their problematic behavior. The environment also offers clues as to how to intervene when a problem arises. Palladino, an associate professor of special education at Eastern Michigan University, teaches and researches in special education services and teaches in the women and gender studies program. He spoke about how gender and environmental messages influence students with EBDs at the University of Nebraska's conference on Women in Educational Leadership held in Lincoln in October. The National Association of School Psychologists defines an emotional or behavioral disorder as: a condition in which behavioral or emotional responses of an individual in school are so different from his/her generally accepted, age appropriate, ethnic or cultural norms that they adversely affect performance in such areas of self care, social relationships, personal adjustment, academic progress, classroom behavior or work adjustment. EBD diagnoses can include schizophrenia, anxiety disorders, affective disorders or sustained disturbances of behavior, emotions, attention or adjustment. Eating disorders, so prevalent in women, also fall the category. Environmental factors are one of the causes of EBDs. They represent the people and systems that affect the student and her relationship between the instructional, social and community environments. These factors directly influence or contribute to gendered responses. Palladino thinks there's another way. He wants to open a conversation about the role that gender and sexuality plays in students with EBDs. “We have to acknowledge the fact that there's a difference between sex and gender,” he said. Behaviors can be considered feminine and masculine. But those terms don't always correspond to the “appropriate” gender. When a female exhibits masculine behavior by being overly aggressive, or a male demonstrates excessive feminine behavior, the resulting backlash can trigger an outburst of bad behavior. Drawing on the work of hip-hop artist Eminem whose songs slur gays, Palladino pointed out that the songs aren't at all about gays or sexuality. “It's his commentary on masculinity; on men who aren't masculine enough,” said Palladino. “The lowest, most degrading thing to say to a man is to call him a faggot.” Too many women athletes are dismissed as lesbians simply because of their prowess at their sport. Being straight and a talented athlete aren't supposed to coexist. Because the processing of messages doesn't happen in a vacuum, students absorb those societal messages and use them to interpret who they are, what the “street codes” mean and the way a student should present herself in school if she wants to be a part of a certain group. Palladino thinks that the part of the code messaging that has to do with sexuality—and how the landscape sends messages about feminine and masculine behaviors—contributes to negative reactions from students with EBDs. A survey of Wisconsin high school students of both genders asked the question, “How would you feel if today you would wake up the opposite sex?” The results were enlightening. Women responded about the opportunities that would await them. “They thought in terms of opportunity,” he said. They could see themselves as professional basketball players, for example. Men's response? They said they would kill themselves. Palladino replicates this survey on his campus every semester. He sends out two pairs of students to 20 sites to ask the same question. His results are the same. Women perceive the opportunity that comes with being male, while men think the idea is a fate worse than death. Applying this understanding to emotional and behavioral disabilities opens the door to questions about just what characterizes deviant behavior. “Sex and gender cause kids to negotiate what good and bad behavior is,” he said. Those negotiations are heavily influenced—both positively and negatively—by social institutions such as work, family, school, religion, media and peer groups. These institutions also influence students’ perceptions of gender divisions. Students with EBDs internalize their environment, which affects how they act out their behavior. We must reclaim the conversations about gender and sexuality to allow all students to feel accepted and nurtured. Contact: john.palladino@emich.edu or 734.487.7120, ext. 2677.

Comparação do desempenho funcional de crianças com visão subnormal e crianças com desenvolvimento normal aos 2 e 6 anos de idade

Vision is a fundamental human sense, as it provides distinct information from that of other senses. There is an association between vision and development, so that reduction of visual capabilities may compromise functioning and independence, as well as other areas of child development. The objective of this study was to compare the functioning of children with low vision and normally developing children, of two and six years of age. In this cross-sectional study 30 children were evaluated, 14 with two years and 16 with six years. They were allocated into two groups: a typically developing and a low vision group, and both were assessed with the Pediatric Evaluation of Disability Inventory (PEDI). Group equivalence was attempted for sex and family's socioeconomic status. The results suggest that children with low vision of two years of age have smaller skill repertoire in self-care and mobility, and they need more assistance from their caregiver, when compared to children of same age with normal development. However, these differences were not manifested with children of six years of age, since children with low vision showed limited performance in the area of self-care, but not in mobility. The results from this study contribute to outline the functional profile of children with low vision, indicating areas that may need to be focused in therapeutic actions, helping guide the intervention process.

J01 EHDN standards of care occupational therapy guidelines

BackgroundOccupational Therapy is an essential component of the management of patients with Huntington's disease throughout the progression of the disease. Occupational therapists aim to enable individuals to maximise function in...

Carer-rated needs assessment of a cohort of people with dementia

With increasing longevity, more people will develop dementia. These people will have a wide range of needs according to their circumstances. Services in the community struggle to meet these needs. This study aimed to identify needs of dementia sufferers attending the South Dublin Old Age Psychiatry service as rated by their carers, to assess the extent of unmet need and the implication of this. The carers of 40 community-dwelling people with dementia attending the service were interviewed by one researcher using the Camberwell Assessment of Need for the Elderly (CANE). This measures a wide range of needs over 24 areas, from personal care, to social, financial and psychological care needs. Qualitative information was also obtained from carers regarding services available and their accessibility. A measure of carer stress and satisfaction with help for this was also obtained. Overall, the highest levels of need identified (both met and unmet) were in the areas of psychological functioning (memory and psychological distress), followed by social needs in the areas of managing money, daytime activities, self-care, and looking after the home. Highest unmet social needs were in the areas of daytime activities, home care and managing money. For 23/24 domains, carers were satisfied rather then unsatisfied with help received. The areas of greatest dissatisfaction to them concerned daytime activities, household skills and self-care. Over half of the carers reported psychological distress. High levels of need, both met and unmet were identified. Many identified needs related to the provision of community supports in the areas of selfcare, household skills and daytime activities, in addition to psychiatric needs. Assessment of needs is important to ensure adequate and responsive service provision, in keeping with the ethos of community care.

Caracterização das habilidades funcionais na síndrome de Rett

O objetivo deste estudo foi identificar as áreas de maior comprometimento nas habilidades funcionais na síndrome de Rett (SR). Foram avaliadas 64 pacientes que preenchiam os critérios para a forma clássica da doença, com idade entre 2 e 26 anos. Foi aplicado o Inventário de avaliação pediátrica de incapacidade (PEDI) que contém 197 itens nas áreas de autocuidado, mobilidade e função social. Dentre as 73 atividades da área de autocuidado, 52 (71,2%) não foram realizadas por qualquer paciente; na mobilidade, dentre as 59 atividades propostas, 8 (13,5%); e na área de função social, dentre as 65 atividades, 50 (76,9%) não foram realizadas por paciente alguma. O desempenho médio ajustado em escala de 0 a 100 para a área de autocuidado foi de 8,9/100, variando de 0 a 19; na área de mobilidade, foi de 30,2/100, variando de 1 a 44; e na de função social, 5,2/100, com variação de 0 a 14. Foi possível verificar fortes correlações entre a área de autocuidado e as de mobilidade e função social; no entanto, entre as áreas de mobilidade e função social não foi detectada correlação significativa. Infelizmente, devido à gravidade da síndrome, o menor comprometimento da mobilidade, comparado ao das áreas de autocuidado e função social, não traz vantagens adaptativas ou maior independência às pacientes com SR.

Experienced Problems of Young Adults With Cerebral Palsy: Targets for Rehabilitation Care

Nieuwenhuijsen C, Donkervoort M, Nieuwstraten W, Stam HJ, Roebroeck ME; and the Transition Research Group South West Netherlands. Experienced problems of young adults with cerebral palsy: targets for rehabilitation care. Objective To determine the problems experienced by young adults with cerebral palsy (CP) and the relationship between those problems and personal and CP-related characteristics. Design Cross-sectional study. Setting Rehabilitation centers in the southwest Netherlands. Participants Young adults (N=87; aged 18–22y) with CP and normal intelligence (roughly corresponding to an intelligence quotient >70, excluding participants who attended schools for those with learning disabilities). Interventions Not applicable. Main Outcome Measures We used the Canadian Occupational Performance Measure in a semistructured interview to assess participants for experienced problems. We further categorized experienced problems according to the domains of the International Classification of Functioning, Disability and Health and assessed the relationship between those problems and personal and CP-related characteristics (eg, age, sex, level of gross motor functioning, manual ability, level of education) using appropriate correlation coefficients. Results Approximately 70% of participants experienced problems in daily life, addressing the areas of self-care (59%), productivity (52%), and leisure activities (37%). More specifically, problems were most prevalent in recreation and leisure (30%), preparing meals (29%), housework (14%), and dressing (14%). Problems in functional mobility, paid or unpaid work, and socialization were considered as most important (represented by the highest mean importance score). Mobility problems were associated with lower levels of gross motor functioning (Spearman ρ =.39), and problems with self-care were associated with lower levels of manual ability (Spearman ρ=.40). Conclusions Although frequently addressed during pediatric rehabilitation care, problems with mobility and self-care still prevail in young adults with CP. In addition, during the transition into adulthood, young adults with CP may experience problems regarding domestic life and work, which they consider important.

Prevalence and impact of physical disability on Malaysian school-aged children: A population-based survey

Purpose. To determine the magnitude and impact of physical disability on Malaysian school-aged children between 7 and less than 18 years old.Method. Cross-sectional population-based household interview with two-stage stratified sampling design.Setting. The Malaysian Third National Health of Morbidity Survey, 2006.Results. Overall prevalence of physical disability was 2.8 per 1000 population among children aged between 7 and less than 18 years old. The commonest cause was congenital, in 61.5% of the affected children. Slightly more than a third of these children with physical disability were partially or totally dependent on their caregivers in the various areas of self care (37.4%) and mobility (34.9%). We also found that the more severe the physical disability, the more adverse impact it had on the functional independence and community participation of these children. Among these children, almost 40% of them had no verbal communication, 31.5% had not attended formal education and 21% were housebound.Conclusion. This population-based survey on physical disability among school-aged children highlighted the key areas where physical disability can greatly impact on the child's function. It has identified the areas of needs that require multisectoral involvement and commitment from the government, non-government and private agencies.

Verificação das habilidades funcionais e necessidades de auxílio do cuidador em crianças com paralisia cerebral nos primeiros meses de vida

INTRODUÇÃO: Paralisia Cerebral é uma desordem do movimento e da postura, persistente, porém variável, surgida nos primeiros anos de vida pela interferência no desenvolvimento do sistema nervoso central, causada por uma desordem cerebral não progressiva ¹. Tem como principal característica a inabilidade do corpo em enfrentar com eficiência os efeitos da gravidade. Devido às alterações motoras é importante a participação do Fisioterapeuta na equipe interdisciplinar. Para tanto, deve-se realizar avaliações das dificuldades na paralisia cerebral para possibilitar uma melhor organização do programa fisioterapêutico. OBJETIVO: Avaliar as habilidades funcionais e a necessidade de auxílio do cuidador em crianças com até 18 meses de idade, e com paralisia cerebral. Método: Foram avaliadas 7 crianças com diagnóstico médico de paralisia cerebral, entre 10 e 18 meses de idade, com média de idade correspondente a um ano e dois meses. A avaliação ocorreu por meio do P.E.D.I. e foram analisados os escores bruto e normativo nas áreas de habilidades funcionais e assistência do cuidador. RESULTADOS: Verificou-se maior dificuldade nas crianças com paralisia cerebral na área de mobilidade e, desta forma, a necessidade de maior assistência em movimentos e posturas. CONCLUSÃO: Apesar das alterações nos componentes neuromotores observadas em crianças de risco, as mesmas acabam desenvolvendo estratégias motoras que lhes permitem desempenhar atividades funcionais, como por exemplo as situações citadas na área de auto-cuidado. Os cuidadores orientados pelo fisioterapeuta podem propor facilitações que beneficiarão a função da criança, sua participação na atividade e desenvolvimento da comunicação.

Desempenho funcional de crianças com paralisiacerebral diparéticas e hemiparéicas

Na Paralisia Cerebral (PC), o ideal é associar o desempenho funcional com características topográficas e alterações de tônus. Entretanto, grande parte da bibliografia descreve apenas a doença e suas conseqüências, e, quando se avalia o desempenho funcional, não se consideram as diferenças existentes nos tipos de PC ou se utiliza apenas um tipo. Na literatura, foi encontrada apenas uma referência bibliográfica que diferencia diparéticos e hemiparéticos quanto ao seu autocuidado, e nenhuma que compare a mobilidade entre eles. Este trabalho teve por objetivo avaliar a relação do desempenho funcional de crianças com PC diparéticas e hemiparéticas. Para tanto, fez-se um estudo transversal com portadores de PC diparéticos e hemiparéticos espásticos, de ambos os sexos, de três a sete anos, que estavam realizando fisioterapia. Excluíram-se crianças que não andavam e (ou) com déficit cognitivo. Foram realizadas entrevistas com cuidadores, utilizando-se a parte 1 (desempenho funcional nas áreas de autocuidado e mobilidade) do Inventário de Avaliação Pediátrica de Incapacidade (PEDI), assim como um questionário com dados pessoais das crianças. Utilizou-se programa BioEstat 4.0, e o teste estatístico Mann-Whitney, para verificação da associação proposta. Aceitou-se α  0,05 como inferência estatística. A amostra foi composta de 40 crianças, 22 diparéticas e 18 hemiparéticas. A maioria era do sexo feminino (53%) e realizava tratamento associado à fisioterapia (88%). A área de autocuidado (p=0,16) não apresentou diferença entre os grupos. Todavia mobilidade, (p=0,02) sugere que o grupo hemiparético possui melhor desempenho funcional. Concluiu-se que os hemiparéticos possuem melhor mobilidade que os diparéticos, enquanto que, no autocuidado, não se observou diferença estatística entre os grupos.

Does Physician Communication Influence Older Patients' Diabetes Self-Management and Glycemic Control? Results From the Health and Retirement Study (HRS)

Effective chronic disease self-management among older adults is crucial for improved clinical outcomes. We assessed the relative importance of two dimensions of physician communication-provision of information (PCOM) and participatory decision-making (PDM)-for older patients' diabetes self-management and glycemic control. We conducted a national cross-sectional survey among 1588 older community-dwelling adults with diabetes (response rate: 81%). Independent associations were examined between patients' ratings of their physician's PCOM and PDM with patients' reported diabetes self-management (medication adherence, diet, exercise, blood glucose monitoring, and foot care), adjusting for patient sociodemographics, illness severity, and comorbidities. Among respondents for whom hemoglobin A1c (HbA1c) values were available (n=1233), the relationship was assessed between patient self-management and HbA1c values. In separate multivariate regressions, PCOM and PDM were each associated with overall diabetes self-management (p<.001) and with all self-management domains (p<.001 in all models), with the exception of PDM not being associated with medication adherence. In models with both PCOM and PDM, PCOM alone predicted medication adherence (p=.001) and foot care (p=.002). PDM alone was associated with exercise and blood glucose monitoring (both p<.001) and was a stronger independent predictor than PCOM of diet. Better patient ratings of their diabetes self-management were associated with lower HbA1c values (B= -.10, p=.005). Among these older adults, both their diabetes providers' provision of information and efforts to actively involve them in treatment decision-making were associated with better overall diabetes self-management. Involving older patients in setting chronic disease goals and decision-making, however, appears to be especially important for self-care areas that demand more behaviorally complex lifestyle adjustments such as exercise, diet, and blood glucose monitoring.

An Internet-based diabetes self-care intervention tailored to self-efficacy

The main objective of this study was to assess whether self-efficacy (SE) could function as a moderator of the effect of a tailored Internet-based intervention aimed at increasing self-reported diabetes self-care behaviours. In a two-group, 1-month interval pre-test-post-test randomized controlled trial, participants (N = 64) were assigned at random to either a group that received an intervention on the area of self-care (blood glucose monitoring, diet management or physical activity) for which the reported SE was lowest (LSE group) or to a group that received an intervention on area of self-care for which the reported SE was highest (HSE group). Improvements in self-care were observed for both groups, but the HSE group improved more. Self-care also increased for those areas that the intervention did not target. Furthermore, SE levels decreased from baseline to follow-up. This study suggests that SE can function as a moderator in a behavioural intervention for diabetes self-care, and hence that initial level of SE provides relevant information for tailoring such interventions.

Self‐care in diabetes: model of factors affecting self‐care

The aim of this paper is to explore self-care in diabetes and to present a model of factors that affect self-care according to reviewed literature. Self-care in diabetes is crucial to keep the disease under control. Self-care consists at least four aspects: (i) self-monitoring of blood glucose, (ii) variation of nutrition to daily needs, (iii) insulin dose adjustments to actual needs and (iv) taking exercise regularly. It is known that diverse factors influence self-care such as knowledge, physical skills and emotional aspects and self-efficacy which have been listed as being of high importance. The searched databases were ProQuest, PsycINFO and Medline from 1995 to 2002. The search terms were "self-care" or "self-management" coexisting with diabetes and "self-efficacy". The search was limited to English and adults with type 1 diabetes. The main components of the model clarify how knowledge, physical skills and emotional factors as well as self-efficacy influence self-care which again affects metabolic control. Flexible self-care indicates high level of self-care when patients are able to care for and manage the disease in a responsible and flexible way that does not affect their life extensively, resulting in adequate glycosylated haemoglobin value. Self-efficacy is a strong predictor of flexible self-care and affects metabolic control through increased perceived ability to conduct self-care. The review illuminated that benefits of self-care should be emphasized and knowledge of the Diabetes Complication and Control Trial results can contribute to better self-care. However, factors affecting flexible self-care still require better identification. The review emphasizes and adds to the topic, that in daily practice health care practitioners must assess diabetes-related knowledge, physical skills and emotional factors in combination with self-efficacy and the four self-care areas. The effects of self-monitoring of blood glucose needs better clarifications as it is now regarded the cornerstone of flexible self-care.

Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement.

To study the convergent and divergent validity of the Canadian Occupational Performance Measure (COPM). Cross-sectional study. The occupational therapy departments of two university hospitals in Amsterdam. One hundred and five consecutive outpatients. The COPM is a measure of a client's self-perception of occupational performance in the areas of self-care, productivity and leisure. Outcome measures of the COPM are: the client's most important problems in occupational performance and a total score for performance and a total score for satisfaction for these problems. Problems reported in the COPM were compared with the Sickness Impact Profile (SIP68), the Disability and Impact Profile (DIP) and an open-ended question. Complete data were obtained for 99 clients. The identification of occupational performance problems with the COPM surpassed the items reported in the SIP68, the DIP and the open-ended question, which confirms the surplus value of the COPM. Divergent validity was further demonstrated by the low correlation coefficients between the total SIP68 scores and the COPM. Seventy-four per cent of the occupational performance problems reported in the COPM had a corresponding item in the DIP and 49% had a corresponding item in the SIP68. Convergent validity was supported by the fact that 63% of the corresponding problems in the DIP were reported to be a disruption of quality of life and 74% of the corresponding problems in the SIP68 were identified as a disability. The results of this study provide supportive evidence for the convergent and divergent validity of the COPM. The data support the assumption that the COPM provides information that cannot be obtained with current standardized instruments to measure health.

The importance of leisure in the lives of persons with congenital physical disabilities.

Although occupational therapists emphasize a balance among the three occupational areas of self-care, productivity, and leisure in people's lives, leisure often is focused on less than the other areas in both the research literature and clinical practice. Very little research has been conducted on the benefits of leisure activities in adults with congenital disabilities. The information contained in this article is a secondary analysis of the interview protocols of nine adults (30-50 years of age) with either cerebral palsy or spina bifida. The primary purpose of the interview was to determine protective processes surrounding turning points in the lives of persons with disabilities. This secondary analysis allowed us to determine the benefits and meaning of leisure for this population. Consistent with literature that focused on either persons without disabilities or persons with acquired disabilities, the participants in the present study reported that involvement in leisure activity provides mental and physical health benefits, enjoyment, opportunity to develop a self-concept and increase self-esteem, and opportunities to build and enhance social relationships. All these benefits enable people to find meaning in life through doing, belonging, and understanding self in the context of their worlds.

COMPENDIUM OF ENERGY COST FOR PHYSICAL ACTIVITIES IN PERSONS WITH SCI

The overall study objective is to develop a compendium of the energy requirements for activities commonly performed by persons with SCI in the areas of self-care, home activities, occupation, leisure/recreation and sport. PURPOSE: Present energy cost data for selected activities in persons with SCI. METHODS: Survey methods were used to establish a list of physical activities commonly performed by persons with tetraplegia and paraplegia. Energy expenditure for selected activities was determined by gas exchange measurement using the COSMED K4b2 portable telemetry system. The selected physical activities were scripted in advance. Subjects were partitioned into two groups upper level injury [C4-T3, (ULI)] and lower level [T4-L5, (LLI)]. Sixteen ULI men, age 41.0 ± 12.9 yr and 28 LLI men, age 41.0 ± 13.1 yr provided data for 9 representative activities, 3 household, wheeling and 2 sport activities. RESULTS: See Table-ULI data on left; LLI data on right. CONCLUSION: When completed, this study will provide epidemiologists with means to quantitatively determine the amount of physical activity that is associated with health in persons with SCI. Supported by the Dept. of Veterans Affairs, Rehabilitation R&D, project B2011-RA.Table: No Caption Available

Starting School: Parents' Perceptions Regarding Their Typically Developing Children and Those With Disabilities

Parents were surveyed in advance of school entry regarding their children's eagerness and readiness for preschool or kindergarten as well as their own attitudes and concerns about the upcoming transition. Parents express positive views of school entry, but a significant minority also voice concerns about their children's safety on the playground, riding a school bus, participating in a large group classroom structure, following directions, and or doing "the work" required. Concerns increase with the severity of disability, especially in areas of self-care, asking for help being understood, and receiving needed services. The majority of all children are reportedly both ready and eager for new challenges, but parents of children with disabilities report significantly less child eagerness to enter the new program than do parents of children without disabilities. These trends again increase with the severity of the child's reported disability. More than half of all respondents wish to receive more information about the new school than they have been given by April of the year prior to transition. Half of all parents volunteer that they want their child to "have friends" or "like school." The authors offer recommendations for transition planning with families and suggestions for community efforts to welcome children and families to the new school.

Self-care in adults with asthma: how they cope.

The purpose of this study was to find out how well adult asthma patients in Finland cope with self-care in three areas of asthma treatment. The areas of physical, psychological and social asthma treatment were examined. Associations between demographic background data and self-care were also studied. Data (n = 130) for the study were collected using a questionnaire specially developed for this study. A deductive perspective was employed in data analysis. Respondents showed fairly good competence in self-care in all three areas of asthma treatment. However, up to 30% of the asthma patients had pets and 16% were smokers. Extra stress was reduced by exercise and positive thinking. Humour was also important in helping most of the respondents cope mentally. Social support played a significant part in fighting the sense of powerlessness which is caused by asthma. According to the results, women coped better than men in the social area of self-care.

Description of retained abilities in older persons with dementia.

There have been suggestions in the literature that the care of people with dementia must be focused on abilities as opposed to disabilities. However, this approach has not been carefully defined in terms of what constitutes remaining abilities. This article provides a description of the abilities in people with dementia, which is based on a descriptive analysis of data derived from a larger study regarding the psychometric evaluation of an abilities assessment instrument. The sample comprised 112 male veterans with dementia who were living in a long-term care facility. Their mean age was 75 years. Data were collected in the areas of self-care, social, interactional, and interpretive abilities. Abilities were retained in all four areas. Furthermore, abilities were differently affected and varied considerably across subjects, which is consistent with evidence pertaining to cognitive changes in dementia. Our results provide support for an individualized, abilities-focused approach to the care of people with dementia.

A Malaysian Experience of Occupational Therapy on the Community

Occupational therapy has been developed to improve the quality of life for people with disability despite their disability, but within their capability. With the influx of technology, most technology biased practising occupational therapists are losing the art and appreciation of the core essence of occupational therapy. Purposeful activity leading to functional performance in the areas of self-care, leisure and productivity—the very core of holistic rehabilitation—is no longer the focus. And holistic rehabilitation is about the successful re-integration of the person with disability into his own community and society, as an asset and not as a liability. The Malaysian experience traces the Community Based Rehabilitation (CBR) approach pioneered by a Malaysian charity foundation, and the roles of the occupational therapists in helping persons with physical handicap lead a more meaningful life.

An Analyses of Research Trend and Proposition Related to Self-care

【This study was performed to analyse the tendency of the self-care studies, to investigate the variables related to self-care, which could be applied for the data establishing the theory of self-care. To accomplish the objectives of this study, the researchers analyzed 83 studies available that contained the area of self-care, which was published in local and foreign areas between 1981 and Feb. 1997. The findings of this study are as follows : 1) Studies published in Korea were about twice more than foreign studies. According to the statistics, the number of studies in this study tended to increase year by year. Between 1991 and 1995 were most. Analysis on the subject of those studies showed, that they were most dealt with chronic diseases an adaults. 2) The theoretical definition of self-care were most referred to Orem's self-care. For the main concept of studies, self care performance was the most. 3) The correlational study was most often used design and experimental study is tended to increase. The questionnares were the most often used data collection method. There was lots of different variable measuring technique to evaluate main concepts. 4) In the results of analysis on the propositions related to the self-care performance, a client's education, social support, self-efficacy, and level of knowledge as a causal variable were found. Also, the physiological index improved and quality of life were found to be significant effective variables.】