• Title/Summary/Keyword: Anxiety group

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CT Evaluation of the Findings of Nutcracker Syndrome in Patients with Bladder Cancer after Radical Cystectomy and Ileal Neobladder Formation: A Correlation with Hematuria (근치적 방광적출 후 회장 신방광형성술을 시행받은 방광암 환자의 컴퓨터단층촬영: 호두까기 증후군 소견의 분석 및 혈뇨와의 관계)

  • Hae Min Shin;Joongyub Lee;Dong Hyeon Lee;Seung Hyup Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.409-417
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    • 2023
  • Purpose Patients with bladder cancer may show hematuria after radical cystectomy with ileal neobladder formation, causing anxiety regarding tumor recurrence. Here, we aim to show that the nutcracker syndrome (NCS) can be a cause of hematuria post-operation, and is a common, rather than a rare syndrome. Materials and Methods A retrospective review of contrast-enhanced abdominopelvic CT (CE-APCT) and urine analysis (UA) findings of 255 patients with bladder cancer who underwent radical cystectomy and ileal neobladder formation between 2011 and 2016 was performed. In the CE-APCT review, the left renal vein flow patterns were evaluated to determine the presence of NCS findings. In the UA review, patients were classified according to the percentage of UA tests with positive hematuria among the total number of UA tests. Results CT findings of NCS were present in 31.9% of the 135 patients. In the positive hematuria group, there were 26% more patients with NCS findings than those without. Conclusion NCS findings are prevalent even for bladder cancer patients after surgery, and there is a strong correlation between NCS findings and hematuria. Furthermore, the prevalence of NCS findings is much higher than urinary tract recurrence after the surgery.

Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery (조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발)

  • HwangBo, Su-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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Development of A Cognitive-Behavioral Anger Control Program and It's Effects on Elementary School Children Under the Anger-inducing Situation (초등학생의 분노유발상황에 초점을 둔 인지행동적 분노조절 프로그램의 효과)

  • Lee, Mi-Gyeong
    • The Korean Journal of Elementary Counseling
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    • v.6 no.1
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    • pp.141-169
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    • 2007
  • One of the most common feelings in everyday life is anger. Anger plays an important role in activating emotional energy and increasing intolerance when confronted with hardships, frustration and improper treatments. And it provides us with controlling interpersonal behavior, organizing internal, physiological, psychological process and various adaptive functions. If anger is not properly expressed, it brings about offensive attitude, leading to not only physical impairment but also anxiety in interpersonal relations and maladaptive to everyday life. For elementary school students, frequent quarrels, abusive words and defiant attitude toward adults are also caused by students' anger. Therefore, students' anger is one of the most difficult problems to be dealt with not only psychologically but also in elementary schools. In this respect, after investigating frequently experienced anger- inducing situations and inventing anger-inducing situation questionnaire, we postulated specific situations changing irrational belief into rational one. Based on these situations, we accounted for how to cope with anger inducing factors and change irrational belief into rational one, introducing several strategies needed to control anger, invented cognitive behavioral anger control program and tried to clarify the relationship between anger inducing experience and anger regulation ability. In order to derive usual anger-inducing situations, we made 180 students with fifth and sixth grade to record the reason why he/she got angry, mood, thought, behavior and result. Through this process, we could derive 47 situations bringing about anger and prepared anger-inducing situation questionnaire. It can be divided into 3 anger inducing situations by using factor analysis into 500 elementary students of fifth and sixth grade. Cognitive behavioral anger control program used in this study consists of 13 sessions. From first to fifth session, it is composed of 10 anger control methods to make students be aware of and control their anger. From sixth through thirteenth session, the relationship between irrational belief and anger inducing is introduced is focused on how irrational belief is changed into rational one. To examine the effects of the program, high anger students and the students lacking anger control are selected. Thirty students through pre-test using anger-inducing questionnaire and anger control ability questionnaire are taught the goals and procedures. Volunteer students and students with parents' consent allocated to experimental group (12 students) and the rest of the students are control group (12 students). Cognitive Behavioral Anger Control Program are applied every 50 minutes twice a week for 7 weeks and 4 weeks before and after this program, anger-inducing situation questionnaire and anger control ability questionnaire are practiced. Data collected in this study analyzed by SPSS and Kwakstat. In the middle of this program, quarterly reports and satisfaction measuratings were evaluated to examine whether there is verbal and non-verbal behavior change and students feel satisfied with the program. The results of this study are as follows: First, Cognitive-behavioral anger control program used in this study effectively reduced anger experience and lasted for 4 weeks. Second, cognitive behavioral anger control program increased students' ability to control anger inducing situations and also effective for 4 weeks. And its effect on verbal and non-verbal behaviour was very impressive Students come to realize that irrational belief is the cause of their anger and actively apply cognitive-behavioral anger control technique to themselves as well. Students became improved in their peer relations and felt confident in everyday life. The overall evaluation of this program can be listed as follows; "very satisfactory (91.67%)", "satisfactory (8.33%)", "very helpful (91.67%)", "helpful (8.33%). In this study we first investigated several anger-inducing situations and invented anger-inducing situation questionnaire and then applied cognitive behavioral anger control program in order to control their. anger and not to experience it. By creating workbooks and manuals this method can easily be used in school education settings.

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A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War (파월국군장병의 고엽제 위해에 관한 예비적 역학조사)

  • Kim, Joung-Soon;Lee, Hyun-Sul;Lee, Hong-Bok;Lee, Won-Young;Park, Young-Joo;Kim, Sung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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A Study on Neurosis According to Experience of Sexual Abuse among Female High School Students in Taegu (대구지역 여고생들의 성(性)적 학대 경험에 관련된 신경증에 관한 연구)

  • Park, Hyung-Bae;Kim, Jin-Sung;Jang, Sang-Ruyl;Rho, Tae-Yong;Suh, Hye-Soo;Kim, Chang-Su;Lee, Kwang-Hun;Kim, Young-Uck
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.113-123
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    • 1995
  • This study was intended to identify the neurotic traits related to sexual abuse in female high school students. The Neurosis Scale of Middlesex Hospital Questionnaire was conducted to 320 female high school students in Taegu, Korea from July 10 to July 17, 1994. The results were as follows: 1) The sexual abuse victim group showed significantly higher neurotic traits of Free floating anxiety (p<0.05), Phobic(p<0.01), Obsession(p<0.01), Somatic(p<0.05), Depression(p<0.01) than the control group. 2) The Neurotic traits of Somatic(p<0.01), Depression(p<0.01), Hysteric(p<0.01) were higher in the multiple-abused than the single-abused. 3) When the duration of being abused was concerned, subjects with more than 1 year duration had significantly higher neurotic traits of Obsession(p<0.05), Somatic(p<0.05), Depression(p<0.05) than subjects with less than 1 year duration. 4) The neurotic traits of Phobic, Somatic, Depression were significantly higher in the subjects with higher intensity of sexual abuse than with lower intensity. S) Among 68 victims, 31 girls(45%) were assaulted by strangers, 10(14%) were by relatives, 7(10.3%) were by siblings, 6(8.8%) were by neihbors. Among them, 34 girls(50%) bad counselling or psychotherapy and the people to whom they had sought for help were friends(23 girls; 68%), parents (7 girls; 11.7%) and mental health professonals (2 girls; 5.9%).

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Space Usage and Satisfaction with Privacy in General Hospital Inpatients (종합병원 입원환자의 공간사용 및 프라이버시 만족도)

  • Choi, In Young;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.36
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    • pp.391-400
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    • 2018
  • To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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Effects of Perceived Stress, Sleep, and Depression on Resilience of Female Nurses in Rotating Shift and Daytime Fixed Work Schedules (순환교대근무와 주간고정근무 여성 간호사의 회복탄력성에 대한 스트레스, 수면, 우울증의 영향)

  • Jeong, Ju Li;Kwon, Hyuk Min;Kim, Tae Hyung;Choi, Mal Rye;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
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    • v.26 no.2
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    • pp.111-124
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    • 2019
  • Objectives: Healthy sleep is important and can have a positive effect on resilience. The aim of the present study was to compare the differences in resilience between two group nurses in rotating shift and daytime fixed work schedules and to investigate stress perception, coping factors, social and psychological health, and sleep factors that may affect resilience. Methods: A total of 400 female nurses having rotating shift and daytime fixed work schedules at two hospitals was surveyed from June 12, 2017 to June 12, 2018. All participants completed perceived stress scale (PSS), stress coping short form (Brief COPE), psycho-social wellbeing Index short form (PWI-SF) or general health questionnaire-18 (GHQ-18), center for epidemiologic studies depression scale (CES-D), STAI-X-1 in state-trait anxiety inventory (STAI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI), Conner Davidson resilience scale (CD-RISC). Independent t-test, paired t-test, Pearson correlation analysis, and multiple regression analysis were applied to the results of the final 373 questionnaires of 400 nurses in two general hospitals. Results: Comparing the variable statistics between the two groups of rotating shift and daytime fixed work nurses, showed statistically significant differences in all variables except perceived stress, sleep quality, and daytime sleepiness. Factors that had a significant correlation with resilience were stress coping strategies, depression, and insomnia severity (p < 0.001). In multiple regression analysis, larger positive reframing1 (β = 0.206, p < 0.001), severe less depression (β = -3.45, p < 0.001), and higher psychosocial health (β = 0.193, p < 0.001). As acceptance coping2 increased (β = 0.129, p < 0.05), as daytime sleepiness decreased (β = -1.17, p < 0.05), and as active coping2 increased (β = 0.118, p < 0.05), as the positive reframing2 increases (β = 0.110, p < 0.05), the resilience increased. Conclusion: This study, it was found that resilience was higher in daytime fixed workers than in shift workers. In addition, specific stress coping strategies, psycho-social health, sleep, and depression factors were associated with resilience.

Risk Factors Related to Development of Delirium in Hospice Patients (호스피스 병동의 암환자에서 섬망 발생 위험 요인)

  • Ko, Hae Jin;Youn, Chang Ho;Chung, Seung Eun;Kim, A Sol;Kim, Hyo Min
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.170-178
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    • 2014
  • Purpose: Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients. We investigated risk factors related to the development of delirium among hospice care patients. Methods: Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests performed at the time of patient's admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox's proportional hazard model was performed using significant factors of logistic regression analysis. Results: Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE < 24), depression ($BDI{\geq}16$), and insomnia ($ISI{\geq}15$) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009~13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009~13.097) were found significant using Cox's proportional hazard model. Conclusion: The development of delirium was significantly related to depression and cognitive impairment among patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.