• Title/Summary/Keyword: 통증정도

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Development of a Measuring Tool for Spiritual Care Performance of Hospice Team Members (호스피스 팀원들의 영적 돌봄 수행도 측정 도구 개발)

  • Yoo, Yang-Sook;Han, Sung-Suk;Lee, Sun-Mi;Seo, Min-Jeong;Hong, Jin-Ui
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.86-92
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    • 2006
  • Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.

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Gender Difference in Quality of Life After Controlling for Related Factors among Korean Young-old and Old-old Elderly (한국 전·후기 노인의 삶의 질 관련요인과 성별 차이)

  • Chung, Younghae;Cho, Yoo Hyang
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.176-186
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    • 2014
  • Objectives: As a sequel to the former analysis of the quality of life (QoL) among young-old and old-old in Korea, this research was aimed to identify factors related to the quality of life and the gender difference after controlling for the related factors among Korean elderly. Methods: Selected elderly data of 1,339 subjects from the 5th Korea National Health and Nutrition Examination Survey conducted in 2010 was analyzed. In this survey, QoL was measured using Euro Quality of Life (EQ-5D) instrument. Data were analyzed using complex survey data analysis on IBM-SPSS 20.0. The related factors were identified using general linear models with backward elimination. The gender difference was tested also using general linear models. Results: The distributions of educational level, family income level, and presence of cohabitant were different between male and female elderly in both young-old and old-old age group. So were the health behaviors and perceived health, and experience of stress, depression, and suicidal thoughts. QoL and its subscales- mobility, self care, daily living, pain and discomfort, and anxiety and depression- were consistently better among male elderly regardless of age group. Among the variables considered, education, family income level, presence of cohabitant, perceived health, age group and BMI were found to be related to the QoL at p=.05, and presence of chronic diseases at p=.10. The difference in QoL between male and female elderly after controlling for the variables was statistically significant. Conclusion: Improving QoL is particularly important for the elderly. In order to improve QoL of the elderly, age- and gender- differences need to be considered when developing services and programs for the elderly.

Effects of the Comfort Promotion Program for Prevention of Delirium among Elderly Patients Hospitalized in Long-term Care Hospital (요양병원 입원 노인환자의 섬망예방을 위한 안위증진 프로그램 개발 및 효과 검증)

  • Hwang, Hye-Jeong;Shin, Yeonghee;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.203-215
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    • 2017
  • Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.

Identification of Genes Connected with the Sensitivity to 5-FU and Cisplatin in Squamous Cell Carcinoma Cell Lines (편평세포암 세포주에서 5-FU와 Cisplatin에의 감수성과 관련된 유전자의 동정)

  • Choi, Na-Young;Kim, Ok-Joon;Lee, Geum-Sug;Kim, Byung-Gook;Kim, Jae-Hyeong;Jang, Youn-Young;Lim, Won-Bong;Chong, Min-A;Choi, Hong-Ran
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.287-300
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    • 2005
  • Squamous cell carcinoma (SCC) in head and neck show a variability in the response to chemotherapy, even when it present with similar histological tumor type, grade, and clinical stage. The purpose of present study it to identify predictive bio-marker for the sensitivity or resistance to conventional chemotherapeutic agents, 5-fluorouracil (5-FU) and Cisplatin Oral cancer cell lines were used in present study. MTT assay was performed to evaluate the sensitivity and/or resistance to 5-FU and Cisplatin. And RT-PCR was carried out for evaluation of the mRNA expressions of various genes associated with mutation, inflammation (COX pathway), cell cycle, senescence and extracellular matrix (ECM). The molecules which are correlated with the sensitivity to 5-FU are XPA, XPC, OGG, APEX, COX-2, PPAR, Cyclin E, Cyclin B1, CDC2, hTERT, hTR, TIMP-3, TIMP-4 and HSP47. And the molecules are correlated with the sensitivity to Cisplatin are COX-1, iNOS, eNOS, PCNA, collagen 1 and MMP-9. Taken together, when choosing the appropriate chemotherpeutic agents for patients, considering the molecules which are correlated or reversely correlated is helpful to choose the resonable agents for cancer patients.

Ablation Rate and Intrapulpal Temperature by Addition of Water Spray During Er:YAG Laser Irradiation (Er:YAG laser를 이용한 치아삭제시 물분사량이 삭제율과 치수내 온도변화에 미치는 영향)

  • Kim, Jung-Moon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.375-381
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    • 2005
  • Er:YAG laser has been considered a promising alternative to dental drill and many researches indicate that adjustment to variable parameters, including water flow rate, pulse energy and pulse repetition rate, can be made to improve ablation ability and efficiency of the laser. Of these parameters, addition of water spray during irradiation has been thought to ablate dental hard tissue more rapidly and safely. The purpose of this study was to investigate tooth ablation amount by Er:YAG laser irradiation as related to varied water flow rates added and, ultimately to find the most effective water flow rate for ablation. In addition, the temperature change of pulp chamber during irradiation was also monitored on the irradiated and opposite pulpal walls, respectively. An Er:YAG laser with contact mode was employed. Extracted human molars were split into two pieces for ablation experiment. Pulse energies of 200 and 300 mJ with a pulse repetition rate of 20 Hz and 5 water flow rates (1.6, 3.0, 5.0, 7.0, and 10.0 ml/min) were applied. Each irradiation was performed for 3 seconds. According to these parameters, experimental groups were divided into 10 subgroups which consisted of 5 specimens. For temperature experiment, another 5 tooth-specimens were prepared in the manner that pulp chamber was open through access cavity preparation and two temperature-measuring probes were placed respectively on the irradiated and the opposite walls of pulp chamber. From the experiment on ablation amount related to different water flow rates, it was shown that the least water flow rate of 1.6 ml/min ablated more than any other water flow rates (p<0.000). When the irradiation for 3 seconds, combined with the pulse repetition time of 20Hz and the water flow rate of 1.6 ml/min was done to tooth specimen, the temperature rise was not noticeable both on the irradiated and the opposite pulpal walls (less than 3$^{\circ}C$) and there was no significant difference in temperature rise between the two pulse energies, 200 and 300 mJ. From the results of this study, it is suggested that tooth ablation with Er:YAG laser can be done effectively and safely at a energy between 200 and 300 mJ/pulse and a pulse repetition rate of 20 Hz when the lasing is conjugated with the water flow rate of 1.6ml/min.

Reliability of Quantitative Sensory Testing Using Current Perception Thresholds in the Mandibular Nerve Area (하악신경영역에서 전류인지역치를 이용한 정량적 감각신경 검사의 재현성 조사)

  • Choi, Hee-Hun;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.131-137
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    • 2011
  • Current Perception Threshold (CPT) using Neurometer($Neurometer^{(R)}$ CPT/C) is thought as one of easy and noninvasive QST(qunatitative sensory testing) tools for A${\beta}$, A${\delta}$ and C fibers within a relatively short time. However, conflicts about its reliability still exist. This study aimed to evaluate the reliability of CPTs evaluation and find a way to increase its reliability. Two examiners separately tested CPTs at each side of the mandibluar nerve areas for ten healthy male adults (average age of 22.4 years) three times with an intervals of a week during three weeks. Mean CPTs were compared between the right and left sides of the mandibular nerve area and between the three examinations on the each side. While CPTs at 2000 Hz(A${\beta}$ fiber) showed statistically significant side differences in all three examinations (p<0.05), significant side difference was found in only one examination at 250 Hz(A${\delta}$ fiber) and no difference at 5 Hz(C fiber). Comparing CPTs on the each side of the mandibular nerve area, all examinations at all sensory nerve fibers showed the least CPTs at the 1st examinations. CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) were significantly different between the first and the following examinations (p<0.05) and there was no significant difference between 2nd and 3rd examinations. The results of this study indicated that CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) are reliable but CPTs at 2000 Hz(A${\beta}$ fiber) is not appropriate for evaluation of side differences in the mandibular nerve area. In addition, it is suggested that repeated examination be helpful to increase reliability of the CPT evaluation.

The Results of Palliative Radiation Therapy in Patients with Unresectable Advanced Pancreatic Cancer (절제 불가능한 췌장암의 고식적 방사선치료 결과)

  • Ryu, Mi-Ryeong;Yoon, Sei-Chul;Kim, Yeon-Sil;Chung, Su-Mi
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.243-247
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    • 2006
  • $\underline{Purpose}$: To evaluate the treatment results and prognostic factors of palliative radiation therapy in the patients with unresectable advanced pancreatic cancer. $\underline{Materials\;&\;Methods$: Thirty-seven evaluable patients with unresectable advanced pancreatic cancer who were treated by palliative radiation therapy for pain relief at the Department of Radiation Oncology, Kangnam St. Mary's hospital, the Catholic University of Korea between March 1984 and February 2005 were analysed retrospectively. There were 22 men and 15 women. Age at diagnosis ranged from 30 to 80 (median 57) years. Twelve patients (32.4%) had liver metastases and 22 patients (59.5%) had lymph node metastases. Radiation therapy was delivered to primary tumor and regional lymph nodes with $1{\sim}2\;cm$ margin, and total dose was $3,240{\sim}5,580\;cGy$ (median 5,040 cGy). Chemotherapy with radiotherapy was delivered in 30 patients (81%) with 5-FU alone (21 patients) or gemcitabine (9 patients). The follow-up period ranged from 1 to 44 months. Survival and prognostic factors were analysed using Kaplan-Meier method and log-rank test respectively. $\underline{Results}$: Overall mean and median survival were 11 and 8 months and 1-year survival rate was 20%. Among 33 patients who were amenable for response evaluation, 7 patients had good response and 22 patients had fair response with overall response rate of 87.9%. Mild to moderate toxicity were observed in 14 patients with nausea, vomiting, and indigestion, but severe toxicity requiring interruption of treatment were not observed. Chemotherapy didn't influence the survival and symptomatic palliation, but the group containing gemcitabine showed a tendency of longer survival (median 12 months) than 5-FU alone group (median 5.5 months) without statistical significance (p>0.05). The significant prognostic factors were Karnofsky performance status and liver metastasis (p<0.05). Age, sex, tumor location, lymph node metastasis, and CA 19-9 level did not show any prognostic significance (p>0.05). $\underline{Conclusion}$: Radiation therapy was effective for symptomatic palliation in the patients with unresectable advanced pancreatic cancer and would play an important part in the survival benefit with gemcitabine or other targeted agents.

Comparative Medium Term Results of Arthroscopic ACL Reconstruction with Quadrupled Semitendinosus Tendon versus BPB tendon (4겹의 반건양건과 골-슬개건-골을 이용한 관절경적 전방 십자 인대 재건술의 중기적 치료 결과 비교)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyeong;Kim, Ki-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.1-6
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    • 2001
  • Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

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The State and Problem of the Soft Contact Lens Wearer (소프트 콘택트렌즈 착용자의 실태와 문제점)

  • Kim, Douk-Hoon;Hwang, Sun-Young
    • Journal of Korean Ophthalmic Optics Society
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    • v.3 no.1
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    • pp.249-258
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    • 1998
  • This study was researched the state and problem of the soft contact Lens wear by the history and inverted microscopy. The results was as follows; 1. The first use of contact lens wear was the 15 years and the last use was the 26 years. The first age of most contact lens wear was the 19 years. 2. In the almost contact lens wearers, the first visual test was the optical shop. 3. At present, almost soft contact lens purchase the optical shop 4. At present, most contact lens wearer like a soft type. 5. At present, most soft contact lens were a domestic production, and some subjects were foreign country production, but some subjects were unknown. 6. After contact lens wear, most subjects don't known the corrected visual acuity, especially, almost people don't known the binocular visual acuity. 7. At present, on soft contact lens color, the teens like the non-color contact lens, twenties like the color contact lens, but thirties was not known. 8. On the advantage of soft contact lens knowledge, most teens and twenties were only one, thirties was unknown. 9. On the disadvantage of soft contact lens knowledge, most teens and thirties were only one, twenties were two. 10. On the side effect of soft contact lens wearer, teens was one, and twenties and thirties don't known. 11. On the main symptoms of soft contact lens wearer, total kinds were seven, On these kinds, most subjects were not symptoms, the next order was unknown on the symptom. But, On the symptoms, the main symptoms was the pain and dry eye. 12. At present, the research on the surface morphology of soft contact lens by inverted microscope, the lens repture, lens folding, foreign body immersion and etc were present. Above the study, most contact lens was soft lens, and the purchase was the optical shop, on the other hand, the knowledge of soft contact lens and visual acuity was few. As a results, On the practical problems of soft contact lens wear, the optician have to the soft contact lens treatment and aftercare by law and educational supporting.

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A study of neuropeptides related to headaches in children with meningeal irritation signs (수막 자극 증상으로 내원한 환자에서 두통과 관련된 신경 펩타이드에 대한 연구)

  • Seo, Bo Gil;Yoo, Myung Hwan;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.533-538
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    • 2006
  • Purpose : The headache, one of the symptoms of meningitis, is related to abrupt elevation of intracranial pressure(ICP) or stimulation of intracranial nociceptive structure. However, in cases of mild elevation of ICP or normal findings of cerebrospinal fluid(CSF) analysis, patients sometimes complain of headaches. Therefore, other pathways may contribute to the occurrence of headaches in aseptic meningitis or meningismus. We intend to investigate the role of substance P(SP) and calcitonin gene-related peptide(CGRP) in aseptic meningitis or meningismus. Methods : We measured leukocyte count, the concentration of protein and glucose in CSF and ICP of patients with meningeal irritation sign. We also measured SP and CGRP levels by using immunoassay. We analyzed the relationship between the presence of headache and the value of SP and CGRP. Results : The concentrations of CGRP($18.8{\pm}10.5ng/mL$) in CSF and ICP($14.8{\pm}4.5cmH_2O$) in aseptic meningitis group were significantly higher than in those($14.1{\pm}7.4ng/mL$ and $12.0{\pm}5.1cmH_2O$, respectively) of the meningismus group(P<0.05). There was no significant difference in the SP levels between the two groups. In the aseptic meningitis group, the concentrations of SP and CGRP were significantly higher in the normal ICP group than in the elevated ICP group(P<0.05). Conclusion : Headaches in children with aseptic meningitis or meningismus is considered to be related to the elevation of the CSF levels of SP and CGRP.