• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.8-18
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• 2019

Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

• Trans-
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• v.16
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• pp.1-31
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• 2024

The advent of digital media has facilitated easy access for adolescents to environments conducive to the purchase of narcotics. In particular, there's an increasing trend in the purchase and consumption of narcotics mediated through Social Network Services (SNS) and messenger services. Adolescents, sensitive to such environments, are at risk of experiencing neurological and mental health issues due to narcotic addiction, increasing their exposure to criminal activities, hence necessitating national-level management and support. Consequently, the quest for sustainable treatment methods for adolescents exposed to narcotics emerges as a critical challenge. In the context of high relapse rates in narcotic addiction, the necessity for cost-effective and user-friendly treatment programs is emphasized. This study conducts a literature review aimed at utilizing digital platforms to create an environment where adolescents can voluntarily participate, focusing on the development of therapeutic content through art. Specifically, it reviews societal perceptions and treatment statuses of adolescent drug addiction, analyzes the impact of narcotic addiction on adolescent brain activity and cognitive function degradation, and explores approaches for developing digital therapeutics to promote the rehabilitation of the addicted brain through analysis of precedential case studies. Moreover, the study investigates the benefits that the integration of digital therapeutic approaches and art therapy can provide in the treatment process and proposes the possibility of enhancing therapeutic effects through various treatment programs such as drama therapy, music therapy, and art therapy. The application of art therapy methods is anticipated to offer positive effects in terms of tool expansion, diversification of expression, data acquisition, and motivation. Through such approaches, an enhancement in the effectiveness of treatments for adolescent narcotic addiction is anticipated. Overall, this study undertakes foundational research for the development of digital therapeutics and related applications, offering economically viable and sustainable treatment options in consideration of the societal context of adolescent narcotic addiction.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.79-89
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• 2023

Background and Objectives: The prevalence of dementia is steadily increasing each year, and preceding studies continue to explore the association between dementia and oral health. Dental hygienists require specialized competencies to provide appropriate dental healthcare services, necessitating the development of a tool for the objective measurement of their knowledge levels. This study aimed to develop a knowledge assessment tool for dental hygienists concerning considerations for dental care for patients with dementia. Methods: The study constructed preliminary items based on a literature review and then conducted expert validation, a pilot survey, and the main survey. The main survey was conducted among 220 dental hygienists. Validity and reliability analyses were conducted with the collected data to select the final items, and the correctness rates for each selected item were verified. Results: As a result of the analysis of the collected data, 18 items were eliminated out of a total of 40 preliminary items, leaving a total of 6 factors and 22 items. The Cronbach's α value for the selected items was 0.791. The six factors are as follows: 'Considerations during dental treatment for dementia patients' (5 items), 'medication side effects in dementia patients' (4 items), 'oral care methods for dementia patients' (4 items), 'communication with dementia patients' (4 items), 'psychological reactions of dementia patients' (3 items), and 'guidance for dementia patients' (2 items). The item with the highest correctness rate was item 2 of the 'guidance for dementia patients' category at 98.6%, while the item with the lowest correctness rate was item 2 of the 'psychological reactions of dementia patients' category at 5.9%. Conclusion: This study validated the reliability and validity of the knowledge assessment tool, which lays the foundation for future research on dental hygienists and dementia. It contributes essential data for ongoing education, development of educational programs, and establishing operational guidelines in healthcare institutions.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.67-75
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• 2018

Purpose The purpose of this study is to investigate and analyze the external dose rates of $^{18}F-FDG$ Whole Body PET/CT patients by distance, and to identify the main factors that contribute to the reduction of radiation dose by checking the cumulative doses of nuclear medicine technologist(NMT). Materials and Methods After completion of the $^{18}F-FDG$ Whole Body PET/CT scan($75.4{\pm}3.3min$), the external dose rates of 106 patients were measured at a distance of 0, 10, 30, 50, and 100 cm from the chest. Gender, age, BMI(Body Mass Index), fasting time, diabetes mellitus, radiopharmaceutical injection information, creatine value were collected to analyze individual factors that could affect external dose rates from a patient's perspective. From the perspective of NMT, personal pocket dosimeters were worn on the chest to record accumulated dose of NMT who performed the injection task($T_1$, $T_2$ and $T_3$) and scan task($T_4$, $T_5$ and $T_6$). In addition, patient contact time with NMT was measured and analyzed. Results External dose rates from the patient for each distance were calculated as $246.9{\pm}37.6$, $129.9{\pm}16.7$, $61.2{\pm}9.1$, $34.4{\pm}5.9$, and $13.1{\pm}2.4{\mu}Sv/hr$ respectively. On the patient's aspect, there was a significant difference in the proximity of gender, BMI, Injection dose and creatine value, but the difference decreased as the distance increased. In case of dialysis patient, external dose rates for each distance were exceptionally higher than other patients. On the NMT aspect, the doses received from patients were 0.70, 1.09, $0.55{\mu}Sv/person$ for performing the injection task($T_1$, $T_2$, and $T_3$), and were 1.25, 0.82, $1.23{\mu}Sv/person$ for performing the scan task($T_4$, $T_5$, $T_6$). Conclusion we found that maintaining proper distance with patient and reducing contact time with patient had a significant effect on accumulated doses. Considering those points, efforts such as sufficient water intake and encourage of urination, maintaining the proper distance between the NMT and the patient(at least 100 cm), and reducing the contact time should be done for reducing dose rates not only patient but also NMT.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.165-173
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• 2004

Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.643-652
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• 2002

As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF＜40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.