• Title/Summary/Keyword: Chronic Illness

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Cost-Benefit Analysis of Back School Program for Occupational Low Back Pain Patients (직업성 요통환자에서 재활 프로그램(Back School Program) 도입의 비용-편익분석)

  • Ju, Yeong-Su;Ha, Mi-Na;Han, Sang-Hwan;Kwon, Ho-Jang;Cho, Soo-Hun;Kim, Chang-Yup;Kim, Sun-Min
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.347-357
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    • 1996
  • Although occupational low back pain accounts for $20\sim40%$ of all occupational illness and injury, there are limited numbers of studies regarding the effectiveness of back school program. The objective of this study was to evaluate the economic benefit of back school program for early return to work of occupational low back pain patients in the current occupational injury compensation and management system. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. The total cost was estimated by calculating the value of components in back school program according to governmental budget protocol. The back school program was consisted of three major approaches, pain center, work-hardening program and funcional restoration program and each of components had various facilities and experts. The total amount of cost was estimated as 250,866,220 won per year. The most promising type of back school program were quite intensive (a 3 to 5-week stay in a specialized center), therefore, if we adopted the 5-week stay course, 10 courses could be held in a year. Following to the medical act, 20 patients per doctor could participate in a each course, ie, total 200 patients in a year. As a result, we could estimate the cost of 1,254,331 won a patient. We estimated the benefit by using data of a few local labor offices about average medical treatment beneficiary and off-duty beneficiary of 46 occupational low back pain patients in 1994. Ullman and Larsson (1977) mentioned that the group of chronic low back pain patients who participated in back school program needed less time to recover by 48.4% of beneficiary duration. And in the trying to estimate the benefit, we asked 10 rehabilitation board certificate doctors about reduction proportion of treatment cost by introducing back school program. The answered reduction proportions were in the range of $30\sim45%$, average 39%. As a final result, we could see that the introduction of back school program in treatment of chronic occupational low back pain patients could produce the benefit to cost ratio as 3.90 and 6.28. And we could conclude that the introduction of back school program was beneficial to current occupational injury compensation and management system.

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Hepatosplenic Scanning with $^{198}Au$ Colloidal Gold in Chronic Myelogenous Leukemia (만성골수성백혈병(慢性骨髓性白血病)에 있어서 $^{198}Au$교질(膠質)을 사용(使用)한 간비주사소견(肝脾走査所見))

  • Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.15-21
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    • 1979
  • From January 1975 to March 1978, 18 cases of chronic myelogenous leukemia diagnosed at Kyungpook National University Hospital were tested by hepatosplenic scanning with $^{198}Au$ colloidal gold. The photo scanning findings in relation to clinical and laboratory findings are following. 1) Male to female ratio was 2:1 and 2nd and 3rd decades were predominant. 2) No focal space-occupying lesion was noticed both in the liver and spleen. 3) 4 cases revealed well visualization of spleen, 7 cases poor visualization, and 7 cases nonvisualization. 4) No significant difference between well visualization group and poor visualization group was noted in clinical findings, liver function test and hematologic findings. 5) Cases with nonvisualization of the spleen tended to be associated with thrombocytopenia, decreased megakaryocytes in the marrow and longer duration of the illness.

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Effects of Bojungikgi-tang on Trimellitic Anhydride-induced Contact Hypersensitivity in BALB/c Mice (보중익기탕(補中益氣湯)이 접촉성 과민반응에 미치는 영향(影響))

  • Park, Yang-Gu;Jung, Myung;Bok, Young-Ok;Lee, Jin-Ho;Kang, Suk-Hoon;Lim, Kyu-Sang;Yun, Young-Gab
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.1
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    • pp.16-32
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    • 2016
  • Objective : The water extract of Bojungikgi-tang (BTE) composed with Ginseng Radix, Astragali Radix, Angelicae gigantis Radix, Atractylodes Rhizoma alba, Aurantii nobilis Pericarpium, Glycyrrhizae Radix, Cimicifuga Rhizoma, and Bupleuri Radix and it has been traditionally used for chronic diseases or weakness after illness in oriental countries. However, little is known about the effects of aqueous extract of BTE on trimellitic anhydride (TMA)-induced contact hypersensitivity (CHS). Therefore, the aim of this study was to investigate the effects of BTE on TMA-induced CHS in BALB/c mice.Methods : In this study, the extract of BTE was prepared by extracting with distilled water at 100℃ for 2.5 h. The extract was freeze-dried following filtration through 0.45 μm filter. Mice were orally administrated with or without BTE extract of different doses (25-200 ㎎/㎏/day) for 28 days. During the challenge period, mice were externally applied with different doses of BTE extract one time per day 30 min before TMA treatment. I examined the effects of BTE on the serum levels of IgE, IgG1, IgG2a, and IgG2b, nitric oxide (NO) and prostaglandin E2 (PGE2) production in isolated peritoneal macrophages, Th2 cytokine production in isolated spleen cells, ear swelling responses, and the leukocyte infiltration induced by TMA.Results : The orally and externally administration of BTE dose-dependently reduced the serum levels of hapten-specific immunoglobulin E (IgE), IgG1 titer, and PGE2 production as well as ear swelling responses and leukocyte infiltration in TMA-induced BALB/c mice. The levels of NO and PGE2 production from peritoneal macrophages stimulated with TMA-BSA were markedly suppressed by pretreatment with BTE in a concentration dependent manner. Furthermore, the levels of Th2 cytokines (IL-4, IL-5, IL-13) production from spleen cells stimulated with ConA were markedly suppressed by BTE treatment in a concentration dependent manner.Conclusions : These results suggest that BTE treatment suppresses chronic contact hypersensitivity, and it can be assumed that the suppression of ear swelling, serum IgE, NO and PGE2 levels, leukocyte infiltration, and Th2 cytokines in an animal model. Therefore, these properties may contribute to the strong anti-CHS response effect of BTE.

A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients (류마티스 관절염 환자 배우자의 부담감)

  • Choi, Kyung-Sook;Eun, Young;Ham, Mee-Young
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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Burden of COPD among Family Caregivers (만성폐쇄성폐질환자 가족의 보호부담에 관한 연구)

  • Kim, Jeong-Hwa;Kim, Eun-Kyung;Park, Sun-Hyung;Lee, Kyung-Ae;Hwang, Yong-Il;Kim, Eun-Ji;Jang, Seung-Hun;Park, Sung-Hoon;Lee, Chang-Youl;Lee, Myung-Goo;Lee, Ji-Yeon;Kim, Dong-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.434-441
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    • 2010
  • Background: Chronic obstructive pulmonary disease (COPD) is a major health problem resulting in significant burden for patients and families. However, family caregivers' burden has not been well recognized. The objectives of this study were to evaluate the level of caregivers' burden and to explore the related factors based on family, patient, and social support factors. Methods: A face-to-face interview with 86 family caregivers who had been taking care of COPD patients was conducted. The participants answered a self-administered questionnaire. The questionnaire included the level of family caregivers' burden, health status and the relationship within the family, functional limitation of patients perceived by family caregivers and the social support. Results: The level of caregivers' burden among participants was considerably high. Risk factors for caregivers' burden included low educational level of family caregivers, low family income, hours of caregiving, and functional limitation of the patients. Protective factors for caregivers' burden were good relationship within the family and support from other family members or friends. Conclusion: It is proved that family caregivers are facing significant burden in taking care of COPD patients. To reduce family caregivers' burden, it is necessary to address socioeconomic status of the family and to provide various community resources including financial support and nursing services.

Model for Cancer Cachexia using C26 Adenocarcinoma-Induced Wasting Syndrome for Newer Therapeutic Approach (새로운 치료 방법 접근을 위한 C26 선암세포 기반의 Cancer Cachexia 동물모델 수립)

  • Eun A Kang;Jong Min Park;Young Min Han;Sung Pyo Hong;Joo Young Cho;In Kyung Yoo;Ji Young Oh;Ki Baik Hahm
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.97-104
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    • 2017
  • Background: Cachexia is a multi-factorial syndrome presenting with chronic illness, decreases in body weight, and loss of adipose tissue and skeletal muscle, mostly in patients with advanced cancer and chronic wasting disease. Even after years of intensive researches, there remains no convincing therapy to prevent cancer cachexia. Methods: In this in vivo study, we have established C26 adenocarcinoma-induced cancer cachexia model in mice to explore the underlying core changes in cytokine, signal transduction, and muscle wasting. The ultimate aim of establishing animal model is to find optimal therapeutics to mitigate cancer cachexia. Results: We have administered C26 adenocarcinoma cells onto BALB/c mice and observed 4 weeks to assess the progression of cancer cachexia. Significant loss of weight accompanied with loss of appetite was noted. As C26 adenocarcinoma xenograft progressed, mortality was started from 3 weeks, accompanied with significant sarcopenia and decreased mice movement. Surges in TNF-α and IL-6 were noted with the commencement of cancer cachexia. Conclusion: Using C26 adenocarcinoma cancer cachexia model, we can screen the optimal therapeutics to mitigate cancer cachexia, in which agents to modulate IL-6, TNF-α, and NF-κB were essential.

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Integrated Medicine Therapy for an End-stage Lung Cancer Patient with Brain Metastasis (양한방 협진을 통한 뇌전이 동반 말기 폐암환자 치험 1례)

  • Park, Seung-Chan;Kim, Do-Hyung;Han, Chang-Woo;Park, Seong-Ha;Lee, In;Choi, Jun-Yong
    • Journal of Korean Traditional Oncology
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    • v.16 no.2
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    • pp.43-51
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    • 2011
  • Objectives : This study reports one case of a patient diagnosed with non-small cell lung cancer with brain metastasis. Methods : A 79 year-old male patient diagnosed with non-small cell lung cancer with brain metastasis was treated chemotherapy for 3 months and quitted it due to poor general condition. He transferred to Korean medicine hospital and was treated herbal medicine(Saengmaek-san plus Baekhapgogeum-tang gagam), acupuncture, moxibustion, interferential current therapy. To evaluate the patient, we measured of Visual Analogue Scale (VAS), Functional Assessment of Cancer Therapy-Lung (FACT-L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Results : Patient's outcomes were improved during the 1st week regarding VAS (41${\rightarrow}$25), FACT-L (81.2${\rightarrow}$90), FACIT-fatigue (25${\rightarrow}$10). However, dyspnea and cough were was aggravated in the 2nd week. Conclusions : Treatment with Korean medicine therapy may have substantial benefit for patients with end-stage lung cancer. But, Integrated medicine therapy is necessary for proper management of end-stage cancer patients.

Effects of a Short-term Life Review on Spiritual Well-being, Depression, and Anxiety in Terminally Ill Cancer Patients (단기 생애회고요법이 말기 암 환자의 영적 안녕, 우울 및 불안에 미치는 효과)

  • Ahn, Sung-Hee;An, Young-Lan;Yoo, Yang-Sook;Ando, Michiyo;Yoon, Soo-Jin
    • Journal of Korean Academy of Nursing
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    • v.42 no.1
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    • pp.28-35
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    • 2012
  • Purpose: This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer. Methods: The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group. Results: There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group. Conclusion: The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.

Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

  • Kim, Hyun-Soo;Lee, Moo-Sik;Hong, Jee-Young
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.69-78
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    • 2016
  • Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.