• Title/Summary/Keyword: 중재지

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Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • 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.

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Nutritional Risk, Perceived Health Status, and Depression of the Young-Old and the Old-Old in Low-Income Elderly Women (저소득층 전기여성노인과 후기여성노인의 영양위험, 지각된 건강상태와 우울)

  • Lee, Myung-Suk
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.12-22
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    • 2012
  • Objectives: This study aimed to compare the nutritional risk, health status and depression levels of young-old (65-74 years) and old-old (75-84 years) women on low-income. Methods: A total of 624 elderly women, each over 65 years of age, participated in this study under the auspices of a community social center. Data were collected from June to August 2011 by means of personal interviews which employed questionnaires. The research tools used in this study were the nutritional risk measuring Mini Nutritional Assesment (MNA) by Kim (2000), perceived health status developed by Lawton et al. (1982), Elderly Depression Criterion developed by Sheikh & Yesavage (1985). The collected data were analyzed using the SPSS WIN 12.0 Program. Results: Nutritional risk, perceived health status and depression levels showed a significant difference between young-old and old-old. There was a positive correlation between nutritional risk and depression and a negative correlation between nutritional risk and perceived health status. A 38.2% variance in depression levels of young-old and a 29.7% variance in depression levels of old-old were explained by perceived health status, nutritional risk and the number of people living together. Conclusion: The findings demonstrate variances in depression levels among low - income women differing in age. As a result, the outcomes of this study ought to be employed in the development of future programs aimed at promoting the health of elderly women.

Factors Related to Health Promoting Behaviors of Young-Old and Old-Old Elderly in Rural Areas (농촌지역 전기노인과 후기노인의 건강증진행위 관련요인)

  • Lee, Myung-Suk;Lim, Hyun-Ja
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.370-382
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    • 2010
  • Objectives: The purpose of this study was to investigate the level of health promoting behaviors and the significant factors in rural elderly(young-old vs old-old). Methods: The data was collected using structured questionnaires from June 22th to Sep. 18th, 2009. A total of 556 elderly aged 65 years or over were selected from 14 rural districts in C province, South Korea. Age was divided into two groups as below 65-74 and 75 or older. A structured questionnaire was used to obtain information on the demographic characteristics, their perceived health status, the difficulty of activities of daily living, quality of life, self-efficacy and health promoting behaviors. The health promoting behaviors included nutrition, stress management, interpersonal support, exercise, health responsibility and self-actualization. The scores for health promoting behaviors were used mean and standard deviation. The data was analyzed using SPSS Win 12.0. Results: Of the 556 subjects, we found that the young-old(65-74 aged) were 359 and the old-old elderly(over 75 aged) were 197. We found that the level of health promoting behavior was higher for young-old ($2.75{\pm}0.374$) compared to old-old elderly people ($2.67{\pm}0.399$). In multiple linear regression, quality of life, self-efficacy, living with spouse, and number of generation living together for the young-old, and quality of life for old-old elderly were significantly associated with health promoting behaviors. Conclusions: The study findings indicate that there are age differences in associated factor of health promoting behaviors. Therefore our findings may provide useful assistance in developing effective intervention programs to improve health promoting behavior of the elderly in rural areas according to their age differences.

The Effects of 8-weeks Jeol Meditation Program on Stress, Depression and Cardiovascular Risk Factors in Women (8주간의 절명상 프로그램이 여성의 스트레스, 우울 및 심혈관 위험인자에 미치는 효과)

  • Jung, HwanSug;Kang, YuneSik
    • Journal of agricultural medicine and community health
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    • v.38 no.3
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    • pp.163-173
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    • 2013
  • Objectives: There has been an increase in the use of mind-body therapies to control cardiovascular risk factors recently. This trial was designed to determine whether the 'jeol'(Korean Buddhists' prostration) meditation program, as a new mind-body intervention, was effective in managing stress, depression and controlling cardiovascular risk factors in women working at a geriatric hospital. Methods: We conducted a randomized controlled trial to determine whether the 'jeol' meditation program could improve stress, anxiety, depression, and cardiovascular risk factors in women. We randomly assigned 57 participants to the intervention(29 participants) or control(28 participants) group. The subjects in the intervention group participated in a group Jeol meditation program once weekly, and practiced at home. The following variables were assessed: stress(Psychosocial Wellbeing Index), depression(Beck's Depression Inventory), body mass index(BMI), waist circumference, hemoglobin A1c(HbA1c), homeostasis model assessment(HOMA), low-density lipoprotein(LDL) cholesterol, high-density lipoprotein(HDL) cholesterol, and triglyceride were assessed. Results: After the 8-week program, 2 participants from the intervention group and 1 from the control group dropped out. The subjects in the intervention group exhibited decreased scores for stress(t=5.102, p<0.01), depression(t=5.259, p<0.01), BMI(t=2.942, p=0.007), and waist circumference(t=2.582, p=0.016); however these scores did not demonstrate a significant decrease in participants of the control group. The other variables showed no significant difference between the groups. Conclusion: The 'jeol' meditation program evidently reduced stress, anxiety, depression, body weight, and waist circumference in women, which suggests that this program could be employed as a mind-body therapies.

Effect of Education for Encouraging Breastfeeding on Practice of Breastfeeding (모유수유(母乳授乳) 권장교육(勸?敎育)이 모유수유(母乳授乳) 실천(實踐)에 미치는 영향(影響))

  • Seo, In-Suk;Jung, Moon-Sook;Suh, Young-Sook
    • Women's Health Nursing
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    • v.6 no.4
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    • pp.632-642
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    • 2000
  • This study was carried out to investigate effect of education for breastfeeding on practice of breastfeeding 171 primiparae (experimental group with education 83 and control group without education 88) who gave birth in hospitals located in Taegu City from October 25, 1999 to December 25, 1999 and planned to breastfeed their children after childbirth. The results of this study were as follows. 1) The experimental group's practice rate of breast-feeding was statistically higher than the control group's at the points of two weeks, four weeks, eight weeks and twelve weeks after childbirth(p<0.05). However, the rate at the points of sixteen weeks and twenty weeks after childbirth was higher in the experimental group than in the control group but there was no significant difference between both groups. 2) The experimental group's discontinuance rate of breast-feeding was lower than the control group's at all the points of two weeks, four weeks, eight weeks, twelve weeks, sixteen weeks and twenty weeks after childbirth, and it was statistically significant(p<0.05). The discontinuance rate of breast-feeding at the point of four weeks after childbirth was the highest in both groups. It accounted for 25.5% in the experimental group and 36.8% in the control group. 3) The reason of which the rate appeared to be the highest among those for discontinuance of breast-feeding was the lack of breast milk. The rate accounted for 65.5% in the experimental group and 50.7% in the control group. In conclusion, the study suggested that the education for encouraging breast-feeding provided to the primiparae after childbirth has an positive effect on the practice of breast-feeding.

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A Meta-Analysis on the Effects of Integrated Education Research (통합교육의 효과에 대한 메타분석)

  • Kim, Jiyoung;Park, Eunmi;Park, Jieun;Bang, Dami;Lee, Yoonha;Yoon, Heojoeng
    • Journal of The Korean Association For Science Education
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    • v.35 no.3
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    • pp.403-417
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    • 2015
  • The purpose of this study was to investigate the effectiveness of integrated education research conducted in Korea and to propose a meaningful discussion for further research. Among the studies conducted for last three years, the relevant 161 research articles were selected, and 236 effect sizes were calculated. Effect sizes were analyzed with different dependant variables including creativity, problem solving ability, academic achievement, inquiry skills, creative personality, scientific attitude, and interests. In addition, effect sizes with different moderating variables, such as characteristics of subjects, sample sizes, class types, core disciplines and publication types, were compared. The results are as follows: The overall effect size of integrated education program produced a huge effect (effect size=0.88, U3=81.06%). Integrated education program showed the highest effect size on scientific attitude among other dependant variables. However, all of the other dependant variables represented more than medium size effect size. Integrated program proved to be more effective on kindergarten pupils and gifted students compared to other school levels and regular students. The effect size for group of less then thirty students were larger than other groups. Programs implemented in after school hours were more effective than in regular school hours. Considering the core subject of program, arts-centered integrated programs showed the largest effect size, while all the others showed above medium effect sizes. Finally, doctoral dissertation showed the highest effect size compared to master's thesis and academic journal articles. Conclusions and recommendations for further research were provided.

A Comparison of Needs for Hospice Care between Families of Children and Adult with Cancer (암 환아 및 암 환자 가족의 호스피스 요구도 비교)

  • Kang, Kyung-Ah;Kim, Shin-Jeong
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.216-223
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    • 2005
  • Purpose: The purpose of this study was to compare the need for hospice care between families of children and adults with cancer. Methods: The data was collected from 190 families of children and adult with cancer using self-rating questionnaires from December, 2004 to February, 2005. Data was analyzed using SPSS/Win program by Mean, SD and t-test. Results: The mean score of the need for hospice care in families of children with cancer was greater significantly than in families of adults with cancer (t=-2.126, P=.035). The scores of two factors among the five factors evaluated for the need for hospice care were different significantly. The mean score of control of major terminal physical symptoms' in families of children with cancer was greater significantly than the mean score of adults with cancer (t=-2.165, P=.032). The mean score of 'spiritual care to prepare for death' in families of adults with cancer was greater significantly than the mean score of children with cancer (t=-2.380, P=.018). Conclusion: For improving the quality of life for both patients and families, the hospice service program needs to consider the life cycle of patients.

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Total Arterial Revascularization Using Y-composite Graft for Isolated Left Main Coronary Artery Disease (단독 좌주간 관동맥 협착병변에서 Y-도관을 이용한 완전 동맥도관 관상동맥우회로 조성술)

  • Ahn, Byong-Hee;Yu, Ung;Chun, Joon-Kyung;Ryu, Sang-Wan;Choi, Yong-Sun;Kim, Byong-Pyo;Hong, Sung-Bum;Bum, Min-Sun;Na, Kook-Ju;Jung, Myung-Ho;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.35-42
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    • 2004
  • Background: For the treatment of isolated left main coronary artery disease, twelve arterial revascularizations with Y-composite grafts using left internal thoracic artery and radial artery or right gastroepiploic artery were peformed. This study was performed to investigate whether V-composite graft can satisfy the blood flow required to make myocardium act properly or not. Borderline stenotic lesions on the left main coronary artery, which are very prone to remodel the bypassed vessels due to competitive flows, were also considered. Material and Method: Among 247 patients who underwent coronary artery bypass grafting from March 2000 to April 2003, 12 patients (4.7%) who had received total arterial revascularizations for the isolated left main coronary artery disease were studied retrospectively. Result: left anterior descending arteries were bypassed with left internal thoracic artery by off-pump technique in all patients, however, 2 cases of left obtuse marginal branches were bypassed under on-pump beating heart. Except for one patient, who did not have an obtuse marginal branch more than 1 mm in diameter, 11 patients had gone through complete arterial revascularizations by use of the Y shape arterial graft. Among five patients who had less than 75% stenosis, one patient showed string sign on left internal thoracic artery grafted to left anterior descending artery. However, two grafts to obtuse marginal blanches were completely obstructed and one showed slender sign. There were no graft-dominant flow in patients with stenotic lesion less than 75%. On the contrary to the result of patients with stenotic lesions less than 75%, all the patients with stenotic lesions more than 90% showed graft-dominant blood flow. Conclusion: In conclusion, it is assumed that, when stenotic lesions are over 90%, coronary artery bypass grafting with an Y shape arterial graft could possibly give enough help to the obstructed coronary arteries in blood supplying to myocardium, which needs massive quantity of blood to act well. However, when patients have borderline stenoses, through scrupulous examinations, more prudent and flexible decisions are required in choosing the treatment methods, such as, direct anastomosis of vein or artery to aorta, or adding supplementary treatment methods like percutaneous coronary intervention, rather than choosing a fixed treatment methods.

Unmet Medical Service Needs in Family Caregivers of Terminal Cancer Patients (말기암환자 가족간병인의 미충족 의료 분석)

  • Shin, Woong Jae;Hwang, Sun Wook;Hwang, In Cheol;Choi, Youn Seon;Lee, Yong Joo;Kim, Young Sung;Shin, Ji Sung;Choi, Young Ho;Rim, Da Won;Kim, Han Sook
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.163-169
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    • 2016
  • Purpose: The unmet medical service needs of caregivers critically influence their caring for terminal cancer patients, but not much research has been done in this regard. Thus, the purpose of this study is to investigate the association between caregivers' characteristics and their unmet medical service needs. Methods: The survey was conducted with 109 family caregivers of terminal cancer patients admitted to four hospice units. The data were collected from March 2014 through December 2014 using a structured questionnaire. The unmet medical service needs were measured using 14 items which were adopted and modified by authors. Results: Seven areas of unmet medical service needs were shown to be significant. A well-educated group showed stronger needs for counsel about cancer screening and complementary-alternative medicine and health supplement food. A never-smoked group was identified with less need for sexual dysfunction counsel. Counsel about family and personal relations was more necessary for current drinkers and current workers, and less necessary for the married. Insurance counsel was more needed for a no-religion group. Occupation counsel was less necessary for healthy patients. Financial support was less necessary for the married group. Conclusion: Based on the results, it is highly recommended to further investigate the unmet medical service needs of family caregivers for terminal cancer patients and causes of the unmet needs.

Distribution and Interrelationship of Smoking, Drinking, and Physical Exercising among Some Rural Adult, an Application of the Transtheoretical Model (행동수정의 단계적 변화론 모형(Transtheoretical Model)에 의한 일부 농촌성인의 흡연, 음주 및 운동행태 분포와 상호 관련성)

  • Lee, Moo-Sik;Lee, Young-Sung;Shin, Hyun-Hwa;Lee, Kun-Sei;Yoon, Seok-Jun;Jung, Ki-Hweon;Kim, Eun-Young;Chun, Byung-Chul
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.113-131
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    • 2000
  • Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.

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