• Title/Summary/Keyword: 수면과 피로도

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The Effect of Physical and Psychological, and Social factors on Health Promotion Behavior among the stroke patients (뇌졸중환자의 신체적, 정신적, 사회적 요인이 건강증진행위에 미치는 효과)

  • Kim, Eun-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.12
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    • pp.8525-8534
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    • 2015
  • The purpose of this study was to investigate relations among the Health Promotion Behavior, Physically, Psychological, and Social factors of the stroke patients. The subjects include the patients that were Stroke was diagnosed and being admitted to hospital. The data of total 223 stroke patients were used in analysis. Collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and Structural Equation Analysis. As a result, The higher medical support health promotion behavior scores were higher. Health Promotion Behavior had correlations with the subjective health state(r=.56, p=.000), family support (r=.68, p=.000), medical support(r=.65, p=.000), Fatigue(r=.27, p=.004), and behavioral intentions(r=.75, p=.000). Factors Affecting Health Promotion Behaviors of the Stroke patients Physically factors of(${\beta}$=-.156, p=.014), Psychological factors of subjective health(${\beta}$ =.283, p=.001), behavioral intentions((${\beta}$=.362, p=.000), Social factors such as family support(${\beta}$=.219, p=.010), the medical support(${\beta}$=.246, p=.004) was found to be significant influence factors. In conclusion, health promotion behavior in stroke patients is subjective health, behavioral intentions, a family support. The higher medical support health promoting behavior appears score was found to be highly Psychological factors and social factors are important factors in promoting healthy behavior. Therefore, psychosocial personalized approach to maintaining the stroke health promotion, health promotion action program itdaneunde be used as basis for relapse prevention is significant.

A COMPARATIVE STUDY ON THE VITAL SIGN AND BEHAVIOR APPEARANCE DEPENDING ON THE ROUTE OF FLUMAZENIL ADMINISTRATION IN CONSCIOUS SEDATION BY MIDAZOLAM (Midazolam을 이용한 의식진정시 flumazenil의 투여경로에 따른 생징후 및 행동양상의 비교 연구)

  • Kim, Hyun-Sik;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.2
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    • pp.159-167
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    • 2002
  • The purpose of this study was to evaluate the efficacy and safety depending on the route of flumazenil, as an antagonist against midazolam. The subjects of this study were 15 volunteers of $22{\sim}24$ years old. They were sedated with midazolam 0.2mg/Kg intranasal spray, and then 40 minutes after midazolam administration, they were given flumazenil 0.2mg intranasal spray for their reversal. For evaluation of the efficacy and safety of intranasal spray for flumazenil, they were monitored with pulse-oxymeter(Nellcor symphony N-3000, Nellcor Puritan CO. USA) and electric sphygmomanometer (Heartcare 200, National CO. Japan), and were assessed themselves using visual analogue scale(VAS) for tranquilization, sleep, fatigue and attitude. All of these subjects were reduced completely without any undesired situations. The results from this study can be summarized as follows ; 1. Nasaly administered flumazenil using spray device produced much more rapid reduction than intravenously administered flumazenil, but soon after fell in more deep sedated state than intravenously administered flumazenil. 2. There were no considerable side effects or bad influence on vital signs of both nasaly administered flumazenil and intravenously administered flumazenil. These results suggested that the flumazenil administered nasaly using spray device for reversal, we could treat patients safely and effectively under conscious sedation using midazolam administration. But, We will have to research about its optimal dosages for flumazenil, used as intranasal spray for reversal agents against the midazolam by evaluating the blood plasma concentration of midazolam and flumazenil.

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Fibromyalgia from the Psychiatric Perspective (정신과적 관점에서의 섬유근통)

  • Lee, Yunna;Lee, Sang-Shin;Kim, Hyunseuk;Kim, Hochan
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.99-107
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    • 2020
  • Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors (암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰)

  • Song, Chi Eun
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.586-600
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    • 2018
  • The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

Differences in sleep quality and fatigue according to gender of shift workers in electronics manufacturing industries (전자제품 제조업 교대 근로자의 성별에 따른 수면의 질과 피로도 차이)

  • Kim, Ki-Woong;Chung, Eun-Kyo;Park, Hae Dong;Kim, Kab-Bae;Kang, Joon Hyuk;Ro, Jiwon;Seo, Hoe-kyeong
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.27 no.2
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    • pp.138-148
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    • 2017
  • Objectives: Sleep quality is directly related to the health, quality of life and working capacity and is affected by age, gender, exercise, life habits. Gender dissimilarities in sleep quality are acknowledged. However, the gender difference in the quality of sleep in shift workers was not well known. Our aim was to study the less known gender differences in the quality of sleep of shift workers. Methods: 1,008 study subjects aged between 21 and 57 years among these, 637(525 male and 112 female workers) were daytime workers and 371(253 males and 118 female workers) were shift workers. Sleep quality was measured by self-report through the Pittsburg Sleep Quality Index(PSQI) and fatigue was measured by using the Chalder Fatigue Scale(CFS). All data was analyzed using SPSS version 19.0 program. The study was approved by the Institutional Review Board of the Occupational Safety and Health Research Institute. Results: Overall, sleep quality was found to be worse in shift workers than in daytime workers and in female than in male. Fatigue in shift female workers was significantly higher than in daytime female workers and shift male workers. In Spearman correlation analysis results, fatigue were significantly associated with gender, drink habit, regular exercise, working hours and sleep quality. With group male workers as the reference, the odds ratio(OR) for having a CFS was 2.115(${\beta}$ value=0.749, p<0.01), and subjective sleep quality, sleep latency, daytime dysfunction and PSQI were 1.541(${\beta}$ value=0.432, p<0.05), 2.297(${\beta}$ value=0.831, p<0.001), 1.798(${\beta}$ value=0.587, p<0.01) and 2.224(${\beta}$ value=0.799, p<0.01), respectively. Conclusions: Shift work played an important role in lowering the quality of sleep, and the effect was more pronounced in female workers than in male workers. Sleep quality was related to fatigue, especially sleep quality, sleep duration, sleep disturbances and daytime dysfunction were significantly related. Therefore, to improve fatigue and sleep quality of shift worker, it is necessary to improve healthy habits such as regular exercise, smoking cessation, and limited drinking. In particular, it is urgent to develop and implement a regular exercise program to reduce fatigue and improve the quality of sleep in workplace.

Prediction Model of Fatigue in Women with Rheumatoid Arthritis (여성 류마티스 관절염 환자의 피로 예측 모형)

  • Lee, Kyung-Sook;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.27-50
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    • 2001
  • Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

Service improving the subjective happiness in Cancer Patient receiving Radiation Therapy (방사선 치료 중인 암환자의 주관적 행복감 향상을 위한 탐색적 연구)

  • Song, Mi Soon;Kim, Hyun Li
    • Journal of Service Research and Studies
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    • v.6 no.2
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    • pp.51-64
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    • 2016
  • This study is to find a service that improves the subjective happiness of cancer patients that receive radiation therapy. One hundred and one cancer patients undergoing radiation therapy were enrolled in the survey to verify the self-consciousness and symptom distress that could affect the subjective happiness. Independent t-test, one-way analysis of variance, and Pearson correlation were conducted with the SPSS 20.0 program. Symptom distress of cancer patients undergoing radiation therapy showed highest in the order of fatigue, appearance changes, dizziness, loss of appetite, and sleep disorders. And lower symptom distress, higher private self-consciousness were significantly correlated with higher subjective happiness among patients receiving radiation therapy for cancer. Study findings reflect the necessity of an integrative approach combining physical, psychological and emotional interventions during a radiotherapy period. For this cause, it would be necessary to supplement previously existing service programs and organize a patient-friendly system that could affiliate regional cancer centers or Public health centers with the hospitals in which the patients are being treated.

Development of Evaluation System for the Cognitive Performance of Marine Officers (항해사 인지능력 평가시스템)

  • Kim, Hong-Tae;Hong, Seoung-Kwon;Barnett, Mike
    • 한국HCI학회:학술대회논문집
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    • 2009.02a
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    • pp.650-653
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    • 2009
  • Decrease in crew performance is frequently cited as a major causal factor in maritime accidents. Although considerable researches on working hours undertaken by seafarers have been conducted through interviews and record analyses, experimental studies on the effects of factors, such as high workload, shift patterns, stress, sleep deprivation, and disturbance on the cognitive performance of mariners have been limited. Other safety-critical transport industries, such as aviation and rail, have developed fatigue management tools to help managements in the work patterns of their operators. Such tools for mariners would assist shipboard crews, marine pilots, and shore managers for planning and improving work schedules. The overall aim of this paper is to determine a fatigue factor that can be applied to human performance data as a part of a software program that calculates total cognitive performance. This program enables us to establish the levels of cognitive performance in a group of marine pilots in order to test a decision-making task based on radar information. This paper addresses one of the factors that may contribute to the determination of various fatigue factors: the effects of different work patterns on the cognitive performance of a marine pilot.

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Effect of Sleep Quality on Fatigue and Quality of Life : a Sasang Constitutional Medicine Perspective (사상체질에 따른 수면의 질과 피로 및 삶의 질 관련성)

  • Park, Ji-Eun;Mun, Sujeong;Lee, Siwoo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.1
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    • pp.37-44
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    • 2020
  • Previous studies have reported an association between poor sleep and various symptoms and diseases, such as fatigue, obesity, depression, and anxiety. The effects of poor sleep may differ by age and sex. In addition, sleep characteristics and their effects may vary according to Sasang constitutional type. The aim of this study was to investigate the associations between sleep quality, fatigue, and quality of life and to assess whether these differ by constitutional type. Participants were individuals aged 40-69 years living in two Korean communities in 2012-2014. Sleep quality, fatigue, and quality of life were measured using the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale, and the 12-item Short Form Health Survey, respectively. The effects of total PSQI score and PSQI component scores were analyzed using a generalized additive model. A Korean Sasang constitutional diagnostic questionnaire was used to assess Sasang constitution. Data for 5,793 participants were analyzed. Poor sleep quality was related to greater fatigue, and lower physical and mental quality of life. The PSQI components including subjective sleep quality, sleep latency, sleep disturbances, use of sleep medications, and daytime dysfunction were associated with fatigue and physical and mental quality of life. Sleep quality was significantly lower in So-Eum compared to So-Yang and Tae-Eum. PSQI component scores for fatigue and quality of life differed significantly by Sasang constitution: for Tae-Eum, sleep latency and use of sleep medications; for So-Eum, daytime dysfunction; and for So-Yang, use of sleep medications and daytime dysfunction. The effects of different aspects of sleep quality differ by Sasang constitution. To improve sleep quality, interventions need to be tailored to constitutional type.