• Title/Summary/Keyword: 증상완화정도

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The Effects of High Dose Rate Brachytherapy in Recurrent Obstructive Bronchogenic Cancer after External Irradiation Therapy (외부 방사선 치료 조사후 재발한 기관지내 악성종양에서 고선량율 근접조사치료(High Dose Rate Brachytherapy)의 효과)

  • Cho, Jae-Youn;In, Kwang-Ho;Suh, Jung-Kyung;Kang, Sea-Yong;Shim, Jae-Jeong;Kang, Kyung-Ho;Kim, Kwang-Taak;Kim, Cheol-Yong;Yoo, Sa-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.68-76
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    • 1998
  • Background: Patients with centrally recurred bronchogenic carcinoma make a complaint of many symptoms like hemoptysis, cough & dyspnea. At these conditions, the goal of treatment is only to relieve their symptoms. High dose rate brachytherapy(HDR-BT) is the palliative treatment modality of centrally located endobronchial tumor regardless of previous external irradiation(XRT) on the same site in symptomatic patients. Methods: We studied the effects of HDR-BT in 26 patients with symptomatic recurrent lung cancer. Patients(male: 24, mean age: 54yrs)were treated with HDR-BT underwent bronchoscopic placement of $^{192}Ir$ HDR after loading unit(Gammamed$^{(T)}$, Germany) to deliver 500cGY intraluminal irradiation at a depth of 1cm every lwk on 3 occasions. Evaluation at base line and 4wks after HDR brachytherapy included chest X-ray, bronchscopy, symptoms (Standadized Scale for dyspnea,cough,hemoptysis), and Karnofsky performance scale. Results: Endobronchial obstruction was improved in 11/26 patients(37%). Atelectasis in chest X-ray was improved in 5/15 patients(33%). Hemoptysis, dyspnea & cough were improved in 5/10 patients (50%), 5/8 patients (62%) & 10/18 patients (56%) respectively. Karnofsky performance status was changed from 76.4 scores in pretreatment to 77.6 scores after treatment. During HDR-BT, massive hemoptysis (2 patients) and pneumothorax(1 patient) were occurred as complications. Conclusion: We concluded that HDR-BT gave additional benefits for the control of symptoms and general performance and endobronchial obstruction & atelectasis. And HDR-BT will be an additional treatment for the recurrent and endobronchial obstructive lung cancer.

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The Need for Child Hospice Care in Families of Children with Cancer (암 환아 가족의 아동 호스피스 요구도)

  • Kang, Kyung-Ah;Kim, Shin-Jeong;Kim, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.221-231
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for child hospice care programs in families of children with cancer. Methods: The survey of 104 families who were taking care of children with cancer was conducted. This survey was conducted from February 2004 to July 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .94 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of 3.40 (${\pm}3.8$). The need for 'emotional care of children' showed the highest mean (M=3.55), 'management of terminal physical symptoms'(M=3.49), 'control of secondary physical problems' (M=3.41), 'acceptance of the family's difficulty' (M=3.20), 'spiritual care for preparing for death'(M=3.17), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the child's mother's age (F==4.980, P=.009), whether or not there were cancer patients among their siblings or relatives (t=2.423, P=.017). Conclusion: The family of children with cancer have a heavy burden of ambivalence, especially in relieving the anxiety and fear of their children, communicating about death, and managing physical symptoms. Child hospice care must be provided considering the needs of families of children with cancer. Thus popular needs as well as hospice nurses' higher concern and support for hospice care of children require further education and program development to meet the current demands.

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The Comparison of Physicians' and Nurses' Knowledge and Attitudes Toward Cancer Pain Management (통증 관리에 대한 의사와 간호사의 지식과 태도 비교)

  • Lee, Eun-Ok;Heo, Dae-Seok;Kim, Soon-Ja;Kim, Yeul-Hong;Yoon, Sung-Soo;Kwon, In-Gak;Cho, Seok-Goo;Park, Myung-Hee;Park, Jung-Yoon
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.7-15
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    • 1999
  • This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

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Current Status of Symptom and Pain Control in Cancer Patients Treated with Chemotherapy (화학요법을 받는 암환자의 증상 및 통증조절 현황)

  • Chung, Young;Na, Duck-Mi;Kim, Jin-Sun;Yang, Kyung-Mi
    • Journal of Hospice and Palliative Care
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    • v.6 no.2
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    • pp.144-151
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    • 2003
  • Purpose : The purpose of this study was to identify the current status of symptom and pain control in cancer patients treated with chemotherapy. Methods : The study population consisted of 66 cancer patients treated with chemotherapy and the data was collected by chart audit and using questionnaire from 19 clinicians in an university hospital during the period of August 7 to 24, 2001. The degree of symptom, analgesics type, dose, administration route, and pain control method of cancer patients treated with chemotherapy was investigated. The collected data were analyzed by frequency, percent, mean, and SD using SPSS $PC^+$ program. Results : The number of cancer patients treated with chemotherapy was 66, male 35 (53.0%), female was 31 (47.0%). The largest of age group was $61{\sim}69$(34.8%) years old. Most frequent cancer site was stomach 19 case (28.8%), cole-rectal 17 case (25.8%), urinary 11 case (16.7%) in the respective order. The most common stage of cancer was stage 3, 14 case (29.2%). The most frequent duration of diagnosis was under 3 month, 25 (37.9%). The frequent symptom of cancer patients treated with chemotherapy was marasmus ($2.4193{\pm}1.2220$), pain ($1.9333{\pm}1.2194$), sleep disorders ($1.7142{\pm}1.0384$), personality change ($1.5806{\pm}0.8971$) in the respective order. 3) The analgesics used for pai control were narcotic analgesics 66.2% and nonnarcotic analgesics 33.8%. Pain control method were regular basis+as needed 47.4%, as needed 31.6%, regular basis 21.0% in order. Administration route were oral 50.7%, injection 41.8%, patch 7.5% in order. Conclusion : The most frequent symptom of cancer patients treated with chemotherapy were marasmus and pain. The frequent analgesics was narcotic analgesics but 21% of the clinician regularly prescribed analgesics for pain control. Thus this prescription was insufficient for pain control. Administration route that were used more oral or injection than patch. Based on this evidence, it seemed that more active practice and education about evaluation and pain control of cancer patients treated with chemotherapy are needed.

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Physical Symptoms and Psychiatric, Social, Spiritual and Economical Care Needs of Patients under Home-based Cancer Service (재가암환자의 신체 증상들과 정신적, 사회적, 영적, 그리고 경제적 돌봄 요구도)

  • Kang, Myung Hee;Moon, Young Sil;Lee, Young Joon;Kang, Yoon Sik;Kim, Hoon Gu;Lee, Gyeong Won;Lee, Won Sup;Kang, Jung Hun
    • Journal of Hospice and Palliative Care
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    • v.17 no.4
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    • pp.216-222
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    • 2014
  • Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.299-306
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    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

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Revision Rotator Cuff Repair (회전근 개 봉합술 후 재수술)

  • Kim, Young-Kyu;Kim, Dong-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.119-125
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    • 2009
  • The primary purposes of revision repair for a failed rotator cuff repair are a relief of pain and functional improvement. Therefore, revision repair is most proper in patients with the functional deficit accompanied with the shoulder weakness as well as the persistent pain. The important factor that is considered in revision repair is a quality of torn cuff. Especially, Care must be taken to ensure that the revision repair is possible, considering the size of tendon defect, atrophy of the muscle, fatty infiltration and extent of the retraction of tendon. Revision repair of a failed rotator cuff repair is more difficult, and the functional results are less satisfactory than those of primary repair, because excessive bursal scarring and tendon retraction may be exhibited, a large or massive tear is often detected, tear has usually been present for a long time, and a quality of muscle-tendon may be poor. So, we discuss our experiences related to revision repair after a failed cuff repair that has been recently introduced through the articles.

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Effects of Perceived Stress, Ego-resilience on Premenstrual Syndrome in Female College Students (여대생의 지각된 스트레스, 자아탄력성이 월경전증후군에 미치는 영향)

  • Yoon, Ji-Won
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.405-415
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    • 2019
  • The purpose of this study was to identify the relationships between perceived stress, ego-resilience, and premenstrual syndrome(PMS) and investigate the factors affecting PMS in female college students. The study participants were 215 female college students in Gyeunggi province. Data were collected from October 10 to November 10, 2017, using self-report questionnaires. Collected data were analyzed using descriptive statistics, Pearson correlation coefficients, and multiple regression analysis. PMS was positively correlated with the perceived stress and negatively correlated with ego-resilience. Eating habits, interference with daily life by menstruation, perceived stress accounted for 44.4% of variance in PMS. Based on these results, it is necessary to develop a management program that integrates psychological factors and lifestyle improvement including dietary habits, as well as efforts to manage menstrual symptoms in order to alleviate the premenstrual syndrome of female college students.

Pain and Factors Influencing Its Management in Patients with Terminal Cancer (말기 암환자의 통증 및 통증관리에 영향을 미치는 요인)

  • Yun, Young-Ho;Heo, Dae-Seog;Kim, Hong-Soo;Ou, Sang-Woo;Yoo, Tai-Woo;Kim, You-Young;Huh, Bong-Yul
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.23-29
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    • 1998
  • Purpose : Validity of WHO guideline of cancer pain management has been proven and many trials were done for resolution of inadequate management of cancer pain. We assessed the severity of pain in terminal cancer patients and patient's characteristics influencing inadequate pain management. Methods : This study was done on 100 patients who was confirmed as terminal in Seoul National University Hospital from lune 1997 to November. For getting the informations about dermographic and medical characteristics such as performance and metastasis, and drug-adjusted pain severity the patients, we reviewed the medical records and interview the patients. we assessed the adequacy of prescribed analgesics with WHO guidelines of pain management, and patient's characteristics influencing on adequacy of pain management. Results : 85.0 percent of cancer patient had pain when diagnosed as terminal cancer and 68% of patient had pain above moderate severity. 38.0 percent of those were given inadequate pain management and the greater pain severity, the less adequate(P<0.001). Sex, age, primary site of cancer, metastasis, symptoms such as depression and anxiety, and performance were not significant. Conclusion : Despite guidelines for pain management, many patients with terminal cancer received inadequate pan management. Their is a need for education about evaluation of pain and guidelines of pain management.

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Factors Influencing Quality of Life of Elders in Urban Regions (일 도시지역 노인의 삶의 질 영향요인)

  • Kim, Eun-Ha;Kwon, Young-Chae
    • Journal of Digital Convergence
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    • v.11 no.7
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    • pp.225-235
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    • 2013
  • The purpose of this study is to investigate the Expected factors on the quality of life and its degree of elders in urban regions. Survey was conducted among 300 elders age of over 65, who attended four schools for elders at Busan metropolitan city in the month of October 2 to October 25, 2012 and data were collected 245 samples. Data analysed by using correlation analysis and multi-regression analysis to recognize the degree of the quality of life of elders and the result showed the expected factors on the quality of life and its major were as follows: First, average score of the quality of life of urban elders was 3.17 (5 scores of scale) and it indicated the medium result; Second, between sub-areas of the quality of life of subjects, significant positive relation was shown among every area excluding depression area;Third, the factors mostly influencing on the quality of life are mental health, social relation, and physical relation in order and it showed a significant level (p<0.001). The study revealed the symptoms of depression which reltaed to mental health, it indicated as a major factor to the quality of life, this study suggest there is requirement of nursing intervention and the application of health program to reduce the depression.