• 한국임상약학회지
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• 제22권3호
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• pp.239-250
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• 2012

In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

• 성인간호학회지
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• 제28권2호
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• pp.213-225
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• 2016

Purpose: The purpose of this study was to provide basic data about agitation in patients with dementia by surveying the literature. Method: Key words used for search through hand-search and electronic database (CINHAL, Pubmed, Google scholar, Riss, Kiss, DBpia) included 'dementia', 'Alzheimer disease', 'agitation', 'aggression or aggressive behavior', 'problem or disruptive behavior', and 'abnormal behavior.' Seventeen studies met the inclusion criteria for the Meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that variables related to agitation were identified as the demographic (age, gender), dementia-related (cognition, medication uses), physical (Activity of Daily Living [ADL], pain), psychological (depression, psychotic symptom, caregiver burden) and environmental (psychosocial environment) factors. The effect size between the correlated variables and agitation were low to moderate (caregiver burden .36; ADL -.24; psychotic symptom and depression .21; pain .19; cognition -.15; medication uses .12; and psychosocial environment -.12). Conclusion: Based on the findings of this study, strategies to improve patients' depressive and psychotic symptoms and ADL and to reduce caregivers' burden are needed for prevention and management of agitation in patients with dementia.

• 대한통합의학회지
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• 제6권1호
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• pp.55-62
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• 2018

Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

• Human Ecology Research
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• 제57권2호
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• pp.201-211
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• 2019

This study examines the effects of chronic disease/disability and stress from health on depressive symptoms among one-person households living in Seoul and Gyeonggi Province in Korea. This study also investigates the moderating effect of social support on the relationship between 1)having a chronic disease/disability and depressive symptoms as well as 2)stress from health and depressive symptoms. This study used data from an online survey targeting one-person households living in Seoul and Gyeonggi Province. The final sample included 499 one-person households. Using a multiple regression analysis with SPSS 20.0, results showed that having a chronic disease/disability was associated with a higher level of depressive symptoms. In addition, stress from health was associated with a higher level of depressive symptoms. In regard to the roles of social support, economic support and emotional support had a direct negative effect on depressive symptoms. Emotional support had a moderating effect on the relationship between having a chronic disease/disability and depressive symptoms. In addition, emotional support also had a moderating effect on the relationship between stress from health and depressive symptoms. Based on these findings, this study suggests that policy makers should reduce the economic burden from a chronic disease/disability and help one-person households to strengthen their social support network.

• 부모자녀건강학회지
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• 제6권1호
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• pp.18-30
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• 2003

Congenital heart disease is the most frequently shown congenital disease among children, most of them can be corrected with operation. However, Patients and their parents need nursing intervention when they face this risky incident of operation. Therefore, parents' experiences are absolutely needed to plan nursing intervention to give practical help to the patients and their parents. The purpose of this study is to provide basic resources to develop a feasible intervention program for the parents by understanding the experiences related to the informed consent of cardiac surgery of their child. From January to June 2003, 10 parents of children patients with congenital heart disease were interviewed who filled out Operation Agreement before the primary operation after they are diagnosed as congenital heart disease in pediatric chest surgery of A hospital in Seoul. They were asked to give opinion regarding pre-operation needs and the interviewed information was analyzed. The results of this study are as follows : Firstly, they were asked what they felt before they were told about the operation of their children from the doctor before filling out the informed consent of operation. They felt 1) vague, 2) confusion of choose, 3) risky, 4) resented, 5) uneasy, 6) guilty, and 7) the burden of operation. Secondly, they were asked what they felt after they filled out the informed consent of operation and the doctor gave them detailed information on the operation of their children. They felt 1) confused, 2) responsible, 3) rejected, 4) angry, 5) plain, 6) to have hope, 7) trying to trust medical people, 8) that consolation is needed, and 9) conditional reduction of the burden of operation. Thirdly, followings are the categories of congenital parents' demand before operation based on the analysis of experiences related to the preparation of the informed consent of operation. 1) Information Demand (1) Anticipatory information (2) Concrete and precise information (3) Individual information 2) Support (1) Empathy (2) Parental supporting (3) Support of parents in the same situation 3) Education and consulting (1) Children-oriented Education (2) Consultation Considering the results of this study, parents of the child with congenital heart disease seem to have various emotional experiences related to filling out the informed consent and they need concrete and practical helps before cardiac surgery. This study proposes that systematic nursing intervention is needed according to the needs of the parents who have the child with congenital heart disease before operation in the field of child health nursing.

• 대한소화기학회지
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• 제72권5호
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• pp.252-257
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• 2018

This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

• 생물정신의학
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• 제23권2호
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• pp.41-47
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• 2016

Dementia with Lewy bodies (DLB) is the second most common causes of dementia. It can exhibit a variety of clinical symptoms including cognitive decline, cognitive fluctuation, visual hallucinations, parkinsonism, REM sleep behavior disorder, hypersensitivity to neuroleptics and autonomic dysfunctions. Despite more well-known criteria for DLB, there are often misdiagnosis and inappropriate treatment. It gives a lot of clinical burden to the clinician as well as to patients and families. When reducing the misdiagnosis, the burden of all will be reduced. The special concern and solicitation are needed in order not to miss the diagnosis when the cardinal features of DLB may not be volunteered by patients and the caregivers. To control the symptoms, clinicians must find and reduce drugs that can have the negative effects on DLB symptoms. There is limited evidence about specific interventions but available data suggest cholinesterase inhibitors improve the cognitive and behavioral symptoms and menmantine slightly improves the global impression.

• Nuclear Medicine and Molecular Imaging
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• 제41권2호
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• pp.102-111
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• 2007

Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the diseases. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

• 셀메드
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• 제14권2호
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• pp.6.1-6.6
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• 2024

The prevalence of respiratory diseases is increasing due to social and environmental factors such as increased environmental pollution and air pollution, and among them, chronic obstructive pulmonary disease (COPD) in particular has a high mortality and morbidity rate worldwide. As a result, medical expenses are rapidly increasing, creating a social and economic burden. In response to this, there is a need to discuss ways to reduce the risk from diseases and manage them appropriately, and the most basic starting point in this process is how these chronic lung disease patients are treated in actual clinical settings and how to improve the quality of treatment. There is a need to look into whether there are effective drugs. Western treatment for chronic obstructive pulmonary disease is basically a disease in which the airway narrows, so bronchodilators are used to widen the bronchi, and corticosteroids and antibiotics are mainly used to relieve the inflammatory response in the lungs. However, since the mainly used Western medicine does not serve as a fundamental therapeutic drug and contains many side effects, there is a need for drugs that improve the quality of life of patients and are more effective in managing symptoms as symptomatic prescriptions. Therefore, Western and Oriental medicine treatments are needed. The purpose is to suggest better treatments through comparative analysis.

• Journal of Microbiology and Biotechnology
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• 제26권9호
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• pp.1657-1660
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• 2016

Prion diseases are incurable neurodegenerative disorders. Our previous study demonstrated that polylysine was effective in prolonging the incubation period in a rodent model and in alleviating the scrapie prion protein (PrP^Sc) burden in the brain at the terminal stage of the disease. Here, we report that intraperitoneal administration of polylysine suppresses the accumulation of prions in the spleen during the early stages of the disease. This study supports the congruence of PrP^Sc inhibition by polylysine in both the spleen and brain.