• 제목/요약/키워드: Chronic Illness

검색결과 435건 처리시간 0.026초

암 환자에 대한 한국어판 FACIT-호흡곤란 10개 항목 단축형 설문지의 신뢰도와 타당도 분석 (Reliability and Validity of Korean Version of FACIT-dyspnea 10 Item Short Form in Patients With Cancer)

  • 구본일;오덕원;이민지;김성경
    • 한국전문물리치료학회지
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    • 제27권2호
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    • pp.111-117
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    • 2020
  • Background: The Functional Assessment of Chronic Illness Therapy (FACIT) for Dyspnea was developed to assess multidimensional dyspnea using two subscales (experience of dyspnea and functional limitation) and a total score. Objects: This study aimed to assess the reliability and validity of the Korean version of the FACIT-dyspnea 10-item short form questionnaire (FACIT-dyspnea-K). Methods: Subjects were 163 patients with cancer. Dyspnea-related scales (modified Medical Research Council scale [mMRC], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30], Hospital Anxiety and Depression [HAD], and WHO Performance Scale) were used to validate the FACIT-dyspnea-K. Results: Internal consistency was confirmed by Cronbach's alpha values of 0.90 and 0.95 in factors 1 and 2, respectively. Convergence validity was determined by comparing the two factors and total score of the FACIT-dyspnea-K with conceptually related assessment tools measuring the physical and emotional effects of dyspnea, with which correlations ranged from 0.364 to 0.567. Criterion validity was established by significant differences in the FACIT-dyspnea-K score between groups when the patients were classified by performance status as assessed by the WHO performance scale. Furthermore, the FACIT-dyspnea-K showed notable correlations with other dyspnea scales (mMRC, EORTC QLQ-C30, and HAD) for cancer patients (r = 0.28 to 0.54). The test-retest reliability of the two factors and total score of the FACIT-dyspnea-K appeared to be excellent (Cronbach's alpha = 0.96 to 0.97). Conclusion: This study supports FACIT-dyspnea-K as a valid and reliable instrument to assess the dyspnea experience of cancer patients in clinical settings.

계지탕(桂枝湯) 방후주문(方後註文)에 관한 연구(硏究) (A study on post-formula instruction of Kyejitang(桂枝湯))

  • 김강;맹웅재
    • 한국의사학회지
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    • 제23권1호
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    • pp.23-41
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    • 2010
  • Greater yang disease(太陽病) is a syndrome induced by peripheral obstruction. One of them is "wind stroke(中風)" with the obstruction in lymphatic system. The other obstruction appearing on circulatory system is called "cold damage(傷寒)." Kyejitang(桂枝湯) is the formula prescribed for greater yang wind stroke pattern(太陽中風證) which is caused by peripheral lymphatic duct obstruction. Ramulus Cinamoni acts as a vasodilator and Radix Paeoniae relieves the abdominal tension. They make blood move to the internal organ and this can remove the retention of peripheral lymphatic system. Covering the patient with a blanket and getting him/her to have hot and thin rice gruel causes slight Diaphoresis, contributing to relieving the retention of lymphatic system. Disharmony between nutrient and defense(營衛不和) means that pressure becomes different between lymphatic system and vascular system. Kyejitang(桂枝湯) is called releasing muscles formula(解肌劑) because it can resolve such pressure difference. Diaphoresis is not a means to eliminate pathogenic qi(邪氣) from the body. That is the syndrome proving that the body fluid has moved around when disordered fluid distribution is corrected. Therefore, diaphoresis should be induced weakly all the time. If diaphoresis is induced excessively, body fluid will move more than desired and then illness cannot be cured. In Sanghanlun(傷寒論), dispersing drugs aim at addressing the retention in the exterior field, but it actually applies to the entire exterior and interior to make body fluid move. Therefore, diaphoresis does not just act on exterior field, and freeing the stool does not only apply to interior field. Distribution of body fluid changed by pathogenic qi(邪氣) influences the whole body because the human body has a closed circulatory system. Sanghanlun(傷寒論) has included treatments for pathogenic disease. However, its value should not be limited to pathogenic disease. It is because controlling blood flow by sending body fluid to the place a doctor wants is certainly worth using for treatment of non-exogenous disease or chronic illnesses.

상완 원위부에 발생한 기무라씨 병 - 증례 보고 - (Kimura's Disease of the Distal Arm - A Case Report -)

  • 윤종필;조기현;민학진;윤의성;서재성;김진수;박철희
    • Clinics in Shoulder and Elbow
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    • 제11권2호
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    • pp.196-200
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    • 2008
  • Kimura씨 병은 원인이 알려지지 않은 만성 염증성 질환으로 주로 동양의 젊은 남자에게 호발되는 드문 질환이다. 주로 두경부의 피하 조직이나 타액선에 무통성의 종괴로 발생하며, 주변의 국소 림프 병증을 동반하기도 한다. 말초 혈액에 호산구 증가증과 혈청 IgE 증가를 나타내고, 조직학적으로 이환된 림프절의 과증식된 배중심과 호산구 등의 염증세포 침윤의 병리 소견을 보인다. 치료 방법으로는 스테로이드 치료, 방사선 치료 및 수술적 치료 등이 있으며 예후는 양호하다. 저자들은 28세 남자 환자의 좌측 상완 원위부 내측에 발생한 종괴를 변연부 절제술을 시행하여, 병리 조직학적으로 Kimura씨 병으로 확진한 1예를 문헌 고찰과 함께 보고하는 바이다.

Efficacy and Safety of Mycophenolate Mofetil in Children with Steroid Dependent Nephrotic Syndrome

  • Lim, Taek Jin;Kim, Seong Heon;Kim, Su Young
    • Childhood Kidney Diseases
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    • 제19권2호
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    • pp.105-111
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    • 2015
  • Purpose: Steroid dependent nephrotic syndrome (SDNS) is a chronic illness in childhood hard to treat. Steroid sparing drugs are often used, because long-term steroid therapy can cause severe side effects. We studied to compare efficacy between MMF and other drugs including cyclosporine and levamisole. Methods: This study was performed retrospectively on patients with SDNS, who were treated at Pusan National University Children's hospital. MMF group included 11 patients who were treated with MMF for at least six months between June 2012 and July 2014. As control groups, cyclosporine group (n=15) and levamisole group (n=18) included patients treated between January 2008 and July 2014. Number of relapse was analyzed in patients treated more than six months, and relapse free for one year was analyzed in patients treated more than one year. Results: In MMF group, ten were boys and mean age at onset was 5.8 years. Mean age at starting of MMF was 8.6 years. Number of relapse in MMF group was reduced significantly after treatment from 3.4 /year to 0.2 /year (P=0.003). There was no significant difference in number of relapse among groups (MMF: 0.2 /year, cyclosporine: 0.5 /year, levamisole: 0.5 /year). Comparing the early relapse within six months after treatment levamisole group was significantly higher than the other two groups (P=0.04). Conclusions: MMF which is used in SDNS significantly reduced the relapse and side effects were rare. In addition, MMF did not show any significant difference in comparison with the other two groups in number of relapse and relapse free for one year.

알레르기 후기 반응 염증 억제 효과에 관한 태음조위탕(太陰調胃湯)의 실험적 연구 (An Experimental Study on the Anti-inflammatory Effect of Taeeumjowui-tang (Taiyintiaowei-tang) in Allergic Late Inflammation)

  • 염유림;정희재;김진주;정승기
    • 대한한방내과학회지
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    • 제31권4호
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    • pp.846-856
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    • 2010
  • Objective : Allergic disease, a very common chronic illness that affects all ages of patients, has been well characterized as an IgE-dependent immunologic response. Recently, interest has grown about the late inflammatory reaction as well as the early one characterized by IgE and mast cells in allergic disease. The purpose of this study was to find the anti-inflammatory effect of Taeeumjowui-tang (Taiyintiaowei-tang) in allergic reaction. Methods : The experiment was performed using Raw 264.7 cells pretreated with Taeeumjowui-tang contents extracts. The results were measured for different concentrations of Taeeumjowui-tang extracts (100, 200, $300{\mu}g$/ml): the toxicity and proliferation of cells by MTT analysis, LPS-induced NO production using Griess reagent and IL-6/ TNF-${\alpha}$ production, which is a significant criteria for diagnosing allergic reaction. Results : No toxicity of Taeeumjowui-tang (100, 200, $300{\mu}g$/ml) on Raw 264.7 cells was found after 24 hours incubation. LPS-induced NO production was reduced after treatment with Taeeumjowui-tang (100, 200, $300{\mu}g$/ml)(P<0.001). IL-6 decreased only at $100{\mu}g$/ml(P<0.05). TNF-${\alpha}$ production decreased only at $300{\mu}g$/ml, but still statistically insignificant. There was no relationship between any components of Taeeumjowui-tang alone and inhibition of NO production. Conclusions : These data suggest that Taeeumjowui-tang has anti-inflammatory effects in allergic reaction.

일본 정신보건복지센터의 운영체계 및 시설유형 분석연구 (1) (A Study on the Management System and the Facility Type of Mental Health and Welfare Center in Japan (1))

  • 임은정;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제20권4호
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    • pp.57-65
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    • 2014
  • Purpose : Mental health service desire has been diversified according to the increase of economic level and rapid social change. Mental Health and Welfare Center(MHWC) is a provider of mental health services in Japan. This is a basic stage study which will suggest the architectural planning guidelines for MHWC. Methods : Data were collected through literature research, field surveys, and expert interviews to 69 MHWC in Japan. 1) Research for the policy and legal aspects of mental health support system. 2) Research for structural aspects of MHWC: Characteristics of establishment, management, and regional factors. 3) Research for the physical environment aspects of MHWC: Classification and evaluation of MHWC's Type by locational characteristics in Japan. Results : The result of this study can be summarized into three points. The first one, Mental Health and Welfare Center's service has being expanded to suicide, depression and stress from chronic mental illness, to reflect social needs. The second one, The average population of area installed at Mental Health and Welfare Center was 2,307,570 person, and average area of the regions were $5,745m^2$. The third one, Mental Health and Welfare Center is divided into single-structure type and combine-structure type. And combine-structure type is divided into medical-combine type, welfare-combine type, and public-combine type.

일부 성인의 주관적 구강건조증에 영향을 미치는 요인 (Adults'self-reported of dry mouth and it's associated impact factors)

  • 박희정;심연수
    • 한국치위생학회지
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    • 제12권5호
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    • pp.973-985
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    • 2012
  • Objectives : The aim of this study is to investigate the possible impact factors on adults' self-reports of dry mouth and to develop strategies to improve oral health education policy. Methods : This study was conducted on a total of 622 self-administered questionnaires adult above 20 and under 65 years of age living in Seoul and Gyeonggi provinces. The final participants consisted of 443 adults without chronic illness, taking medications and wearing dentures. The Hierarchical Multiple Regression model with three stages was used to assess the association for exposure of interest, such as socio-demographics, health-related behavior, mental health and self-reported of dry mouth. Results : The participants reported mean score of dry mouth($6.32{\pm}4.47$), of which 191 were male($6.81{\pm}4.56$) and 252 were female($5.94{\pm}4.37$). Hierarchical Multiple Regression revealed that the score of dry mouth was shown to be significantly higher for the following people: Males, who were employed, unemployed, negative self-perceived general health, perceived stress, and participants who had no experience awareness of distress in two weeks. The explanatory power was 21.9%. The most powerful impact factor regarding to employment was shown to be negatively associated to dry mouth, and self-perceived general health, experiencing awareness of distressful in two weeks was also important factors. Conclusions : Based on these results in order to develop oral health education policy strategies for the prevention and management of dry mouth, there need to be considered for the employee.

ICF 모델에 근거한 재가노인의 도구적 일상생활수행능력 구조 모형 (A Predictive Model of Instrumental Activities of Daily Living in Community-dwelling Elderly Based on ICF Model)

  • 박용경;서순림
    • 한국콘텐츠학회논문지
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    • 제18권2호
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    • pp.113-123
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    • 2018
  • 본 연구는 WHO의 ICF(International Classification of Functioning, Disability and Health) 모델을 기반으로 재가노인의 도구적 일상생활수행능력 모형을 구축하였다. 연구 대상자는 65세 이상의 재가노인 260명이었고, 자료 분석은 SPSS Windows 18.0과 AMOS 18.0을 이용하였다. 모형의 적합도 검정 결과 모든 지수 기준을 충족하여 모형을 수용하기에 적합한 것으로 판단하였다. 연구 결과 재가노인의 도구적 일상생활수행능력에 직접적인 영향력이 가장 큰 요인은 신체 심리적 상태였다. 즉, 주관적 건강상태가 좋을수록, 우울이 낮을수록, 만성질환이 적을수록 도구적 일상생활수행능력이 좋았다. 직접적인 영향력이 두 번째로 큰 요인은 시각-운동 통합능력으로 확인되었고, 세 번째로 큰 요인은 사회활동이었다. 도구적 일상생활수행능력에 간접 영향을 미치는 변수는 개인 요인, 사회적 지지, 사회활동 순이었다. 도구적 일상생활수행능력에 대한 이들 변수의 설명력은 32%였다.

고령화 한국사회의 노인 고독사: 위험요인과 예방전략 (Lonely Deaths among Elderly People in the Aging Korean Society: Risk Factors and Prevention Strategies)

  • 김혜성
    • 한국콘텐츠학회논문지
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    • 제17권8호
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    • pp.454-462
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    • 2017
  • 본 연구는 노인 고독사 현상에 대한 이해를 목적으로 미디어 자료를 사용하여 고독사 사례를 살펴보고자 하였다. 질적 연구방법으로 사례분석 방법을 적용하였다. 고독사 사례는 2007년부터 2017년 초까지 보도된 미디어 자료를 사용하였다. 자료 수집은 인터넷 검색 엔진을 사용하여 수행하였으며, 총 47사례가 최종 분석에 사용되었다. 60대 21사례, 70대 17사례, 80대 이상 9사례를 분석에 사용하였다. 성별은 남성 22사례, 여성 17사례, 성별미상 사례 8사례로 나타났다. 분석 결과, 고독사 사례에서 나타난 주요 위험요인으로는 빈곤과 경제적 곤경, 만성질환, 정신건강 문제, 사회적 고립, 가족 및 이웃과의 관계 절연, 실업, 1인 가구, 독신 혹은 이혼, 그리고 대도시 거주 등으로 파악되었다. 연구 결과를 바탕으로 향후 예방 전략에 대한 논의를 제기하였다.

Anterior Interbody Grafting and Instrumentation for Advanced Spondylodiscitis

  • Lim, Jae-Kwan;Kim, Sung-Min;Jo, Dae-Jean;Lee, Tae-One
    • Journal of Korean Neurosurgical Society
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    • 제43권1호
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    • pp.5-10
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    • 2008
  • Objective : To evaluate the surgical outcomes of ventral interbody grafting and anterior or posterior spinal instrumentation for the treatment of advanced spondylodiscitis with patients who had failed medical management. Methods : A total of 28 patients were evaluated for associated medical illness, detected pathogen, level of involved spine, and perioperative complications. Radiological evaluation including the rate of bony union, segmental Cobb angle, graft- and instrumentation-related complications, and clinical outcomes by mean Frankel scale and VAS score were performed. Results : There are 14 pyogenic spondylodiscitis, 6 postoperative spondylodiscitis, and 8 tuberculous spondylodiscitis. There were 21 males and 7 females. Mean age was 51 years, with a range from 18 to 77. Mean follow-up period was 10.9 months. Associated medical illnesses were 6 diabetes, 3 pulmonary tuberculosis, and 4 chronic liver diseases. Staphylococcus was the most common pathogen isolated (25%), and Mycobacterium tuberculosis was found in 18% of the patients. Operative approaches, either anterior or posterior spinal instrumentation, were done simultaneously or delayed after anterior aggressive debridement, neural decompression, and structural interbody bone grafting. All patients with neurological deficits improved after operation, except only one who died from aggravation as military tuberculosis. Mean Frankel scale was changed from $3.78{\pm}0.78$ preoperatively to $4.78{\pm}0.35$ at final follow up and mean VAS score was improved from $7.43{\pm}0.54$ to $2.07{\pm}1.12$. Solid bone fusion was obtained in all patients except only one patient who died. There was no need for prolongation of duration of antibiotics and no evidence of secondary infection owing to spinal instrumentations. Conclusion : According to these results, debridement and anterior column reconstruction with ventral interbody grafting and instrumentation is effective and safe in patients who had failed medical management and neurological deficits in advanced spondylodiscitis.