• Title/Summary/Keyword: Burden of support

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Hematologic Toxicity in Patients Undergoing Radical Anti-cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India

  • Roy, Soumyajit;Mallick, Supriya;Raza, Md. Waseem;Haresh, Kunhi Parambath;Gupta, Subhash;Sharma, Daya Nand;Julka, Pramod Kumar;Rath, Goura Kisore
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3587-3592
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    • 2014
  • Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.

Decision Making Experience on Breast Reconstruction for Women with Breast Cancer (한국 유방암 여성들의 유방재건술에 관한 의사결정 경험)

  • Yi, Myungsun;Joung, Woo Joung;Park, Eun Young;Kwon, Eun Jin;Kim, Haejin;Seo, Ji Young
    • Journal of Korean Academy of Nursing
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    • v.46 no.6
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    • pp.894-904
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    • 2016
  • Purpose: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. Methods: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. Results: Five theme clusters emerged. First, "expected loss of sexuality and discovery of autonomy" illustrates various aims of breast reconstruction. Second, "holding tight to the reputation of doctors amid uncertainty" specifies the importance of a trust relationship with their physician despite a lack of information. Third, "family members to step back in position" describes support or opposition from family members in the decision making process. Fourth, "bewilderment due to the paradox of appearance-oriented views" illustrates paradoxical environment, resulting in confusion and anger. Lastly, "decision to be made quickly with limited time to oneself" describes the crazy whirling process of decision making. Conclusion: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.

The Meaning of Chemotherapy in Cancer Patients (암환자가 체험한 화학요범의 의미)

  • Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.151-181
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    • 1998
  • This study purports to find out the meanings of chemotherapy among cancer patients. The subjects of this study were selected from those patients who have taken chemotherapy at least twice at a hospital affiliated with a university. The twelve subjects agreed to join the present study and had no problem in communication with others. The data were collected through observations and interviews by the researcher. The phenomenological analysis method proposed by Giorgi was adopted for analyzing the data. The experiences of the subjects to chemotherapy were classified into 24 atributes. These attributes were also categorized into four groups such as hope, pain, fear, and ordea according to their meanings. The subjects expressed hope through the attributes such as "the wish for a new life." "the wish for healing." "the plasure form improvement of cancer." "the wish for being discharged form a hospital." "the interest in dietectic treatment." and "the trust in medical staff." Pain was represented by such attributes as "the physical pain", "the suffering from intravenous injection." "the discomfort of hospital environment." and "the economic burden." As for the attributes represention fear, "fear of being hospitalized." "tehr obscurity of uncertain situations." "the fear of side effects." "the fear of recurrence of cancer," "the lack of knowledge of the disease." Finally, nine attributes werw frouped to ordeal "the will endeavouring to recover cancer" "the adaptation to the present situation." "the giving up of being healthy," "the regret of the past life." "the recognition of significant others." "the physical changes." "the emotional changes." "the social changes." "the recollection of illness experiences." The above findings indicate that chemotherapy means hope, pain, fear, and ordeal to those cancer patinests under treatment. Hence, the nursing interventions for those cancer patients need to be directed to maintaining hope, alleviating pain and fear, and overcoming ordeal. There are some suggestions in achieving these goals : (1) the nurses caring for cancer patients need to understand the meaning of chemotherapy experienced by those patients, (2) a nursing specialty of intravenous injection needs to be developed, (3) interventions for providing emotional support should be devised, (4) nursing care should also be available to those cancer patients being dischaged at home.

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Survey and Suggestions on the Educational and Research Environment of Graduate Students of Korean Medicine: Focusing on fostering of KMD-scientist (한의사과학자 양성을 위한 한의학과 대학원 재학생의 교육 및 연구환경 실태조사와 제언)

  • Myungsun Kim;Myung-Ho Kim;Minjung Lee;Dongyeop Jang;Sa-Yoon Park
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.59-73
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    • 2023
  • Objectives: The role of physician-scientists who bridge the gap between basic science and clinical medicine is crucial in advancing medical innovation. This study aims to examine the educational and research environment and career satisfaction of graduate students in Korean Medicine among those who are Korean medicine doctor (KMD). Methods: This study analyzed the results of a survey consisting of respondents' composition, job status, graduate education and job satisfaction, economic conditions, career determinants, and obstacles to the career path of KMD-scientists from 65 participants including both full-time and part-time graduate students. Results: The results revealed significant differences between full-time and part-time graduate students in terms of weekly hours spent and job priorities, motivation for entering graduate school, career preferences, and desired career paths. The study highlights the need for tailored support for full-time and part-time graduate students and the importance of economic assistance in fostering KM scientists. Economic difficulties were identified as a major obstacle for full-time graduate students pursuing research careers. Tuition fees were found to be a significant burden for all graduate students. Furthermore, it emphasizes the importance of enhancing the research capabilities of part-time graduate students and improving the quality of education to foster KMD-scientists. Conclusion: This research provides essential insights for Korean Medicine colleges and graduate schools to develop targeted improvement plans and effectively train KMD-scientist.

Two Year Experiences of the International Elective Clerkship for Medical Students (2년간의 의과대학 학생의 해외임상실습 경험)

  • Lee, Sam-Beum;Bang, Jae-Beum;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.24-29
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    • 2009
  • Background : The aims of medical education have recently been changing in Korea, which has been accompanied by efforts to modify the rotating clerkship courses, improve the quality of clinical education, and make global doctors. We report the experiences of medical students going through an international elective clerkship for during past two years. Materials and Methods: Third year medical students could apply to the international elective clerkship course during a 4 week period alter their third-year rotating clerkship at a university hospital. This was done twice - in 2008 and in 2009. Applicant students were allowed to select hospitals anywhere in the world. We analyzed their choices including data on nation, state or city, hospital or institute, contacted hospitals by medical college, differences of two years, etc. Results : Twelve students (10.9%) of a total of 75 third-year students applied to 3 nations and 4 hospitals in 2008. Nine students applied to the Tampa General Hospital at the University of South Florida (USF) in the USA, which was arranged by their medical college. In 2009, a total of five (4.2%) of 77 students applied to 2 nations and 3 hospitals, including three at the University of South Florida, one in another city in the USA, and one in another nation because of the increased financial burden due to a higher exchange rate. Conclusion: Medical students started their first international elective clerkship courses during the past two years. Experiences were interesting and meaningful to the students and the medical college. Greater effort and support to developing a new paradigm and to enlarge the scope of the program for making global doctors are required in the future.

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Grandmothers' Experience of Child Care with Grandchildren: A Grounded Theory Approach (손자녀를 돌보는 외할머니의 양육경험: 근거이론적 접근)

  • Won, Mi-Ra;Lee, Sun-Hee;Kim, Hyun-Kyoung;Yoo, Hye-Yeong;Park, Jung-Uk
    • Korean Parent-Child Health Journal
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    • v.15 no.1
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    • pp.39-49
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    • 2012
  • Purpose: This study examined grandmothers' experience of child care with grandchildren to understand how it affects their stage of life based on the methodology of grounded theory. Methods: This study used grounded theory, a method of qualitative study, as the theoretical foundation. The subjects of this study were 10 grandmothers who have reared their grandchildren for at least 6 months and volunteered to participate in the study after listening to an explanation. Resources were collected through in-depth interviews and the interviews were recorded and dictated. Results: The core category of participants in this study was "solidifying the family relationship". There were five steps in the process of "solidifying the family relationship". The first step of process was "affection motion" of rearing to help their daughters. The second step was "conflict" due to physical constraint and burden of child care. The third step was "acceptance" based on compensation and support and the fourth step was "development" in search of their ego. The last step was "integration" of family relationship. Conclusion: This study provided basic data for appropriate nursing intervention to grandmother to care for their grandchildren according to the five steps of grandmother's child care experience process.

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Hormone & Osteoporosis (홀몬과 골다공증)

  • Han, In-Kwon
    • 대한근관절건강학회:학술대회논문집
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    • 1996.04a
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    • pp.110-121
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    • 1996
  • It is well defined that osteoporosis is an age related disorder and associated with decreased bone mass. It is one of the most important disease lacing the aging population because of its association with fracture of the hip, vertebrae and distal radius. The disease provoke a significant economic burden and major public health problem of an elderly. The life-time risk of hip fracture in white women is approximately 15% which is equal to the combined risk of breast, uterine, and ovarian cancer. Despite its deleterious effect on women's health, knowledge of the epidemiology of osteoporosis in Korea is only beginning. 1970 in Korea has non as the crossover period between the chronic and an Infectious diseases. As the result, the infant mortality declined and an elderly population in Korea increased significantly in the past decade, The average life expectancy of women in Korea is now about 75 years. Thus, the majority of Korean women will spend approximately one-third of their life in the postmenopause state. Therefore, better understanding of bone metabolism and fracture incidence in Korean population is a great interest for the medical community as well as for public health. Currently, no population based epidemiologic data are available to support the incidence of osteoporotic fractures in Korea. However, available data suggest that significant declining of bone mineral density (BMD [g/$cm^2$]) has been occurring in Korean women after menopause. In same population, peak BMD was observed around 33-39 years of age and continue to decline thereafter. An accelerated bone losses occur after the menopause and the average loss is approximately 13% within 15 years from the menopause. The incidence of fracture was highly correlated with an age and bone mineral density. The mean age of menopause in Korean women was 47 years and this age appears to getting younger when analyzed by the birth cohort. An earlier menopausal age and increase life expectancy place Korean women at increase risk for osteoporosis and bone fracture. Korean or Asian women are no longer protected from the risk of bone fracture. Therefore, an early prevention or intervention schemes are essential before the outbreak of osteoporosis and/or fracture occurs in Korean or Asian women.

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Living Arrangements Affect Nutritional Status of the Elderly

  • Kim, Cho-Il;Lee, Haeng-Shin
    • Journal of Community Nutrition
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    • v.3 no.2
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    • pp.103-109
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    • 2001
  • With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.

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The Relations Among Self-esteem, Stress and Coping Behaviors of Mothers with Handicapped Children (장애아 어머니의 자아존중감, 스트레스 및 대처행동간의 관계)

  • Kim, Mi-Hye
    • The Journal of Korean Academy of Sensory Integration
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    • v.5 no.1
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    • pp.1-20
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    • 2007
  • Objective : The purposes of this study were two-fold; First it investigated self-esteem, stress and coping behaviors of mothers with handicapped children as a function of their and their children's characteristics; Second it examined the relationship among these variables. Method : The subjects were 294 mothers of handicapped children who were receiving treatment in one of the sixteen special therapy institutions in Seoul, Gyeonggi-do, and Gangwon-do. Rosenberg's(1965) Self-Esteem Scale translated by Jeon Byung-Jea(1974) was used to measure the degree of mothers' self-esteem. Mothers' stress was assessed using the Support Burden Scale revised by Seong Jong-sook(2000) and their coping behavior was examined using Folkman's(1986) Coping Scale translated by Jeon Sung-hye. The data were analyzed with descriptive statistics, t-test, one-way ANOVA and Pearson's Correlation. Result : The major results of this study were as follows; First, working mothers of handicapped children showed higher self-esteem and problem solving coping behavior more than non-working mothers. Self-esteem was found higher with high-income mothers than with low-income ones. Stress was shown more intense to low- and middle-income mothers than to high-income ones. Problem solving coping behavior was preferred more by high-and middle-income mothers than by low-income ones. Second, mothers with the mild-handicap children showed higher self-esteem than those with the first-degree handicap ones. Mothers of children with first-, second- and third-degree handicap perceived more stress than those with mild handicap. Coping behavior was significantly different depending on the severity of children's handicap, but no significant difference was found among the groups. Third, the higher the self-esteem of mothers was, the less they perceived stress and used more of problem solving coping behavior. When mothers perceived a great deal of stress, they used more of emotion-oriented coping behaviors.

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An Introduction of Urbani School Health Kit Developed by World Health Organization (세계보건기구의 Urbani School Health Kit 소개)

  • Nam, Eun-Woo;Chang, Chang-Gok;Park, Soon-Woo;Bonito, Sheila;Kim, Tae-Ho;Shin, Hai-Ri
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.1
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    • pp.117-129
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    • 2011
  • Objectives: The purpose of this study was to introduce of the Urbani School Health Kit (USHK) and to investigate the adaptability to Korean situation. Methods: The authors analyzed the contents of USHK developed by the health promotion team at the Western Pacific Regional Office of World Health Organization (WHO WPRO) in collaboration with health promotion experts at University of the Philippine Open University, and by observing health classes using the USHK in Angono elementary school in Manila, Philippines. Results: The following are the characteristics of USHK: 1) The USHK was composed of a teacher's guide and six books targeted to two groups of children: ages 5~6 years and 10~12, and an integrated package containing materials that can be used to support health education and health promotion activities in elementary schools. 2) The USHK could be integrated in the curriculum to reduce the burden of teacher's class preparation time and help teachers conveying clear and accurate health messages in their classes. 3) Several evaluation tools such as pre-test post-test quizzes, self-evaluation tools, observer checklists, and evaluation interview protocols were developed to monitor and evaluate whether USHK was useful, helpful, and appropriate. Conclusions: We found that USHK was a practical tool for supporting health promotion in elementary schools and could be applicable to health promoting schools in Korea if it were modified to address Korean school health problems.

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