Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
Journal of Hospice and Palliative Care
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v.11
no.1
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pp.42-50
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2008
Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.
Kim, Myo-Youn;Park, Yeon-Hwan;Park, Dar-Lee;Hwang, Yeon-Ja;Chang, Hee-Kyung
Asian Oncology Nursing
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v.9
no.2
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pp.104-113
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2009
Purpose: The aim of this study was to investigate pain management knowledge and attitude in cancer patients and their family caregivers. Methods: The subjects were 52 hospitalized cancer patients and 52 their family caregivers in a hematooncologic unit in one general hospital. Data were collected via self-reported questionnaires and interviews in 2008. Results: 46.2% of the patient participants reported pain and 50% of them were taking opioid analgesics. Levels of knowledge about cancer pain and its management in both patient and caregiver participants were low, whereas, the scores of knowledge of the caregivers were significantly higher than that of the patients. The attitudes toward cancer pain were not significantly different between patients and caregivers. Both cancer patients and caregivers had some misconcepts in using opioid analgesics and about cancer pain. Patients' and caregivers' level of knowledge about cancer pain and its mangement demonstrated positive correlation. Conclusion: Education about cancer pain and its management should target both cancer patients and their family caregivers. Also the education should focus on intervening the misconceptions that patients and their caregivers have regarding cancer pain and its management.
This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.
This study was conducted with 200 outpatients and inpatients of military hospitals around the northern region of Gyeonggi-Do. 182 questionnaires in 200 copies were returned, which meant that the return rate was 91%. 180 questionnaires were used for analysis because 2 questionnaires included untrustful responses. The questionnaires were filled by the subjects for 20 days from Dec. 1, 2008 to Dec. 20, 2008. First, in accordance with the examination on the awareness and knowledge on the dental caries, periodontal disease and oral health care, the awareness on the prevention of dental caries was 18.733 points in 25 full points. Second, for the examination on the oral health status according to the interest and education related to oral health care, the interest and oral health status showed the statistically significant relationship(P=0.0083). Third, in accordance with the analysis on the relationship between oral health status and awareness and knowledge on oral health care, for the awareness on the prevention of dental caries, the answer "Not healthy" was 19.188 points, the answer "Average" 18.210 points and the answer "Healthy" 18.971 points. In conclusion, the higher the interest on the education and oral health care was, the better the behavior for oral health care and oral health status were. As a result, the oral health care is essential for each individual to keep good health status. For keeping and deploying the best fighting power in the military and the country, the oral health program shall be pushed ahead as the key project to keep the good oral status of soldiers.
Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.
Stroke is a serious disease despite recent improvements in the medical treatments available. Thirty-six stroke patients were interviewed as case and 36 non-stroke patients were interviewed as controls between February 2005 and August 2005 at Daegu S Medical Center. Information regarding the subjects' food habits was collected using the recall method from 5 years before the onset of stroke. Using interview techniques, we investigated how dietary habits and attitude influence nutrient intake. These results were analyzed by the $X^2$, Student's t-test and Chi-square test using the SPSS 12.0 program. This case-control study was performed to demonstrate the relationships among general quality factors (BMI, WHR, and family history of stroke) and lifestyle factors (smoking, exercise and alcohol drinking). The results were as follows. Analysis of the percentage of nutrient intake in terms of meal pattern showed that WHR was significantly higher in the case group than in the control group. Hypertension and diabetes were the most common preceding diseases associated with the risk of stroke. The frequencies of smoking, alcohol consumption (p<0.001) and exercise (p<0.05) were higher in the cases than in the controls. Thus, the findings of this study are consistent with those of previous studies and suggest that people should be advised to control hypertension, smoking, alcohol drinking and obesity in order to prevent the occurrence of stroke as these factors are major risk factors for stroke.
Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.
This study is to observe the effectiveness of the applied model and to present the improvement plan and directions for development for the case management practical model suitable for the actual condition of Korea Labor Welfare Co. and needs of the industrial injury patients. The concrete purpose of this study is: First, observe the difference of stressor experience and experience degree between the experimental group and the comparative group. Second, observe the difference of stress of the experimental group and the comparative group. Third, find out how the stress affects the support degree and satisfaction degree. Fourth, present the improvement plan of case management model, which can promote the psychosocial rehabilitation of the industrial injury patient based on the research results. The outline of the main research results identified in this study is as follows. The stressors the industrial injury patients perceived are health problems, family matters, the problems concerning hospital recuperation (hospital staff and environmental problems), economical problems, problems of coming back to society, problems with companies, problems with Korea labour Welfare Co. and other problems. And the experience of stressor was prominently lower in experimental group than comparative group in the whole problem, health problem, problems with Korea Labour-Welfare Co. and other problems. The stressor experience degree was conspicuously lower in experimental group in the whole problem experience degree, health problem experience degree, problem with Korea Labour Co. experience degree and other problem experience degree. Besides whether or not the case management is applied is having a prominent affect on the primary factor affecting the stressor experience degree, therefore the patients applied with case management has less stressor than the patient who didn't. The difference of degree of tension experienced by the stressor in both groups, the degree of stress, was not conspicuous in statistics so it shows that the application of case management in this research has not affected the degree of tension. The field which had been the most help was emotional support in help level the experimental group perceived through applying case management about industrial accident patients and recuperation, compensation problem, medical treatment problem, family matters has been helpful in this order. The help level of the whole problem was in higher level than the middle value. The stress factor which affects the case management problem settlement is the whole body of stress. The satisfaction level of help through applying case management was highest in emotional support and family matters, recuperation problem, company problem, compensation problem, and medical treatment problem was the next highest. The satisfaction level of the whole problem was higher than the middle value. The stress factor affecting the satisfaction level of help is the whole body of stress. Therefore to reduce the stress level of industrial accident patients and for them to come back to local societies, we need to reinforce the continuance and responsibility of case management model, increase staff, reinforce the role of counsel and medical treatment, intervene in the patient's plan of leaving the hospital, develop social support system and the need to establish After Care Center.
This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.
Park, Minsu;Min, Ji Hong;Ko, Sung Hwa;Lee, Sang Won;Ko, Hyun-Yoon;Shin, Yong-Il
재활복지
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v.21
no.2
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pp.247-259
/
2017
We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.
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