• Title/Summary/Keyword: Chronic Illness

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Alexithymia and Pressure Pain Threshold in Patients with Somatoform Disorder who have Pain (동통을 가진 신체형장애 환자에서 감정표현능력과 압통역치)

  • Song, Ji-Young;Kim, Tae-Soo;Oh, Dong-Jae;Yoon, Doh-Joon;Yum, Tae-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.2 no.1
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    • pp.69-79
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    • 1994
  • The authors investigated the relationship between the response to the external stimulation and ability of verbal behavior in the patients with somatoform disorder who have pain. The subjects consisted of 34 patients(male 10, female 24) and 37 normal controls(male 19, female 18). Pressure pain thesholds were measured by algometer and alexithymia was assessed by Toronto Alexithymia Scale(TAS). Somatization Scale of SCL-90R and Parental Bonding Instrument were also used. It was shown that 82.4% of the patients had chronic somatic complaints. The mean values of TAS, degree of somatic symptoms and pressure pain thresholds were significantly higher in the patient group than in the normal controls. 44.1% of the patients was considered alexithymia group and there was no correlation between scores of alexithymia and value of pressure pain thresholds. In conclusion, the patients with somatoform disorder who had pain were dull in pain perception to external physical stimulation. This result suggested that their low perception of pain could be closely related with chronicity of illness. And the Poverty of verbal expression of inner emotion was suggested to be one of the factors affecting somatization and difficulty in psychotherapy.

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Shade Comparative Analysis of Natural Tooth using Spectrophotometric Methods (분광측정기를 이용한 자연 치아의 색조 비교 분석)

  • Kim, Sa-Hak;Hwang, Seong-Sig;Lee, Hye-Eun
    • The Journal of the Korea Contents Association
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    • v.16 no.2
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    • pp.772-781
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    • 2016
  • This study is to set the objective criteria on maxillary incisors shade selection by using the colorimetric Shade-Eye NCC as measuring in CIE $L^*$, $a^*$, $b^*$ values, and look into the meaning by analyzing its values. We explain the purpose of this study and gotten their agreement from patients visiting the dentist, 111 people's (men 50, women 61) three teeth, the maxillary central incisor, maxillary lateral incisor, maxillary canines, total of 333 teeth colorimetry. As a result of comparing the differences in colors between cervical margin and incisal edge, ${\Delta}E^*$ of canine is shown as low as $5.81({\pm}2.98)$, followed by lateral incisor of maxilla as $6.51({\pm}3.23)$ and central incisor of maxilla $7.51({\pm}3.04)$. Females show higher luminosity(L*) than males do in all teeth- central incisor, lateral incisor and canine; in yello chroma(b*) males' central incisor is slightly higher than that of females (p<0.05). Age significantly influences the luminosity and red (a*) and yellow chroma (b*) of central incisor(L*); the luminosity(L*), and yellow chroma(b*) of lateral incisor and canine (p<0.05). Smoking doesn't significantly influence the color of natural teeth. Drinking reduces the luminosity of central incisor as well as red chroma of lateral incisor(p<0.05). A chronic illness is likely to reduce the luminosity of central incisor and lateral incisor(p<0.05).

Pilot Study on Characterization of Patients with Low Back Pain: Multi-center, Prospective, Observation Study (요통 환자의 특성 조사 예비 연구: 다기관, 전향적, 관찰연구)

  • Park, Chang-Hyun;Jang, Bo-Hyoung;Ko, You-Me;Park, Dong-Su;Kim, Soon-Joong;Park, Won-Hyung;Cha, Yun-Yeop;Ko, Seong-Gyu;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.123-132
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    • 2016
  • Objectives The aim of this study done as pilot study is to analyze the current state of patients who have low back pain through registry. Methods This study is done under approval of Gil Oriental Medical Hospital of Gachon University, Oriental Medical Hospital of Sangji University, Jecheon Oriental Medical Hospital of Se-Myung University IRB. Among subjects who signed the consent form by their own will, we decided whom to register as subjects of this study by the standard of selection and exception. We collected the sociological investigation, character of low pack pain, degree of symptom which they felt before and after the hospitalization from registered subjects. Results 1. The number of the subjects is 16. The average age is 41.0. 9 of them are female, 7 of them are male. Most of the subjects have history illness which has connection with low pack pain. 2. According to the patient's free description of the back pain, 6 of them suffered throbbing pain. And 8 of the patients have chronic pain, 6 of them have intermittent pain of back pain analysing the character of the low back pain. They answered the pain lasted for 47.6 minutes on average. 3. About the change on the average R.O.M. of L-spine, R.O.M. of Lateral bending, Extension, Flexion, Rotation has increased after leaving the hospital compared with before hospitalization. 4. The amount of discomfort or strength of pain, which was checked by VAS on the day of leaving the hospital, has decreased than they were before the hospitalization. And there was the improvement on the dysfunction score and EQ-5D. Conclusions Through this study, we specifically analyzed the symptoms of the low back pain by accumulating the analysis about the symptoms using several indicators and description which is freely spoken by patients about their symptoms. Further research is expected to complete multi-center registry by building registry and by using it, to get various epidemiologic informations about low back pain.

Prediction Model for Reduced Bone mass in Women using Individual Characteristics & Life Style Factors (여성의 개인적 특성과 생활양식요인을 이용한 골량감소 예측모형)

  • Lee, Eun-Nam;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.83-109
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    • 1998
  • This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

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A Comparative Study on BMI, Pain, Depression, Self-esteem and Self-efficacy between Rheumatoid Arthritis Patients and Osteoarthritis Patients (류마티스 관절염과 골관절염 환자의 BMI, 통증, 우울, 자아존중감 및 자기효능에 대한 비교 연구)

  • Hwang, In-Ok;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.11 no.2
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    • pp.187-198
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    • 2004
  • Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

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Reliability and Validity of the Korean Version of the Recovery Assessment Scale(RAS) for Psychiatric Patients (정신과 환자를 위한 한국판 회복평가척도(Recovery Assessment Scale)의 신뢰도 및 타당도 연구)

  • Lim, Kyung-Min;Shin, Eun-Sik;Shim, Sun-Hwa;Jeong, Yoon-Ju
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.628-638
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    • 2014
  • The aim of this study was to explore the reliability and validity of the Korean version of the Recovery Assessment Scale in psychiatric patients. The original RAS was translated into Korean and the content was verified through back-translation procedures. This study included 142 patients who had chronic mental illness and were aged 18 or older. The subjects were assessed by using RAS-K, the 12-item Dispositional Hope Scale(DHS), the 28-item Mental Health Recovery Measure(MHRM), the 32-item Behavior and Symptom Identification Scale (BASIS-32). In the reliability test, Crobach's a coefficient and test-retest reliabilities were 0.92 and 0.79, respectively, indicating that the RAS-K has good internal consistency. In the analysis of the concurrent validity of the RAS-K, there were significant correlations between the RAS-K and DHS(r=.675, p<0.01), and between the RAS-K and MHRM(r=.816, p<0.01), but lower correlations with symptoms and clinician-related measures of psychiatric functioning. Factor analysis resulted in a five factor solution accounting for 62.476% of the common variance. Our study indicates that the RAS-K is an appropriate instrument to assess recovery in Korean psychiatric patients.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Effects of Granting Wish to Children with Life-threatening Conditions on Adjustment to Disease with a Focus on the Mediating Effects of Resilience and Stress Caused by Diseases (소원성취 프로그램이 소아암 및 난치병 환아들의 질병 적응에 미치는 영향: 레질리언스와 질병 스트레스의 매개효과를 중심으로)

  • Lee, Kwang Jae;Choi, Kyung Il
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.148-155
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    • 2015
  • Purpose: The purpose of this study is to examine how wish granting influences children with life-threatening medical conditions when it comes to their adaptation to disease with a focus on the mediating effect of resilience and stress caused by disease. Methods: From January 2, 2015 through January 12, 2015, a survey was conducted on 292 children with life-threatening diseases whose wishes were granted through Make-A-Wish Korea. The data were collected using the impact of a wish scale, the Children's Adjustment to Cancer Inventory, the Childhood Cancer Stressor Inventory, and the resilience scale in children with chronic illness. The data were analyzed using SPSS/WIN 20.0 and Amos 21.0. Results: Satisfaction with the wish granting program enhances resilience, and resilience affects stress caused by medical conditions as well as adaptation to disease. Also, stress caused by medical conditions influences adaptation to disease. Conclusion: Wish granting is effective in both facilitating chronically ill children to adjust to disease and reduce their stress from disease. Thus, children with life-threatening medical conditions could be assisted or motivated to adjust to disease by improving satisfaction achieved by wish granting.

The correlation analysis between fatigue and health promoting life style among a rural college students (일 지역 대학생의 피로와 건강증진 생활양식과의 관계분석)

  • Jang Hee-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.477-492
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    • 1999
  • The disease patterns among the Korean was shifted from acute and infectious diseases to chronic diseases. According to the these disease patterns trends, people have concerned about the health promotion and health behaviors. Pender's(1996) revised health promotion model(HPM) is consist of three categories; Individual characteristics and experiences, Behavior-specific cognitions and affect, behavioral outcome. Of these categories, individual characteristics and experiences, this category of variables is considered to be of biological, psychological and socio-cultural personal factors, especially, individual fatigue. Futhermore. these variables constitute a critical core for nursing intervention, as they are subject to modification through nursing actions. But there is no few the research of the relationship between the fatigue and health promotion. Therefore, the purpose of this study is to investigate the correlation between the fatigue and health promoting life style among a rural college students. Additionally, this descriptive correlational study identified the relation of demographic factors and fatigue, health promoting life style. From June 20 to 26, 1998, a convenience sample of 270 college students completed the questionnaire of the fatigue and health promoting life style profile which were developed by the Yoshitake(1978) and Walker, et al.(1987), respectively. The descriptive correlational statistics, mean, t-test, ANONA, Pearson correlation coefficient were used to analyze the data gathered with SAS pc+ program. The results were as it follows: 1. The average fatigue score of the subjects was $64.93{\pm}12.89$. Fatigue scores by subcategory were physical symptoms($23.5{\pm}4.87$). psychological symptoms($22.11{\pm}4.66$) and neuro-sensory symptoms($19.32{\pm}5.14$). With the respect to the demographic characteristics of the subjects, there were statistically significant differences between the demographic factors and fatigue, especially, sex(t==3.69 p<0.01), major(t=-2.89 p<0.01). the experience of family illness(t=2.76 p<0.01). 2. The average health promoting life style item score of the subjects was $2.33{\pm}0.33$. In the subcategories, the highest degree of performance was self-actualization(2.94), following interpersonal support(2.81). stress management(2.33), exercise(2.20), nutrition(2.10), and the lowest degree was health responsibility(1.73). There were the significant differences on the learning of health education(t=2.00 p<0.01). religion(F=3.01, p<0.05), circle activity(t=2.07, p<0.05), nutrition control(t=5.25, p<0.01) of demographical factors with the health promoting life style. 3. The correlation between the fatigue and health promoting life style made statistically no significance(r=-0.09731, p>0.05). But there was negative significant relationship between health promoting life style and psychological symptom as a fatigue subcategory(r=-0.15721, p<0.05). The self-actualization showed negative significant correlation with all fatigue subcategory. The health responsibility showed significant relationship with total fatigue(r=0.13050. p<0.05). For further research, it suggests to replicate the correlational and causal study between the fatigue and the health promoting life style using the another fatigue scale which is able to measure the subjective and objective fatigue degree. And it needs to develop the nursing intervention program for maintaining and promoting the health behavior as well as for decreasing the college students's fatigue.

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A Bibliographical study on Lumbago in Oriental Internal Medicine (내과(內科) 영역(領域)의 요통(腰痛)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Yoon, Cheol-Ho;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.15 no.2
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    • pp.318-346
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    • 1994
  • A Bibliographical study was done about lumbago in oriental internal Medicine. The results are as follows. 1. Shenxu,sexual active, senile, Feng, Han, Shi, shiji, Tanyin and Qi lumbago are applicable to internal medical lumbago in oriental medicine, and Shenxu is essential pathogenesis. 2. Shenxu lumbago is characterized by continous pain, improved after chiropsia, deep pulse in Chi pulse, and used QingeWan, LiuweiDihuangWan and AnshenWan in herb-medicine. and Cortex Eucommiae, Radix Rehmanniae Praeparata and Fructus Psoraleae in drugs for the purpose of ZishenYijing, and related to lumbago caused by chronic prostatitis, calculus or tumor in kidney and diabetes mellitus. 3. Sexual active lumbago is dim-aching and weak pain in or after sexual life at low back and knee joint, and classified to Shenyang Buzu, ShenjingKuisun. GanshenYinxu and XinshenBujiao ; Liuwei Dihuang Wan, ZuoguiWan In herb-medicine. Cornu Cervi Pantotrichum, Fructus Lycii and Fructus Corni in drug were used for treatment. 4. Senile Lumbago is a kind of consumptive disease due to exhaused essential energy and caused by lack of Shenjing, Yangqi ; and described as repeated mild dim pain and ErzhiWan, QingeWan and MoyaoGao were used frequently, supposed to connected with osteoporosis, osteomalacia and osteoarthropathy deformons caused by aging. 5. Feng lumbago is attacked by Liuyin, and characterized by chilling and fever. stabbing pain from thoracic and lumbar vertebrae to pedes, and used WujiXan, XiaoxumingTang for treatment. Han lumbago is caused by cold's attacking Shenjing, distinguished for chilling,icing sense improved by heat on low back, and used WujiXan, JiangfuTang. Shi lumbago is caused by damp's inflowing Shenjing, described as stone-like lumbago which was subsided low back pain growing worse by gloomy rain, and used ShenshiTang. ShenzhuTang for the purpose of ZaoshiXingqi. And it is supposed that lumbago occured in the initial of urinary track infection was belong to those of Feng,Han and Sill's. 6. Sillji lumbago is caused by pathogen being in the spleen and the stomach, and used ChenxiangJiangqiTang, PingweiSan for treatment. And it is supposed that it belong to lumbago caused by gastrointerstinal disease such as peptic ulcer. gastroduodenal tumor and colonic inflammatory disease. 7. Tanyin lumbago is caused by Tanyin's flowing meridian, characterized by thoracolumbar verterber's heaviness, covered sense with something on low back and painless massage. Kuaiqi-drug are added to ErchenTang, DaotanTang for treatment, and it supposed that Tanyin lumbago's belong to that accompanied with metabolic disease such as obesity and gout. 8. Qi lumbago is caused by excessive stress such as melancholy and fury, described as multiple stabbing pain, an unexpected on and improvement, ranging back pain until flank and abdomine. Tiaoqi-drugs were added to RenshenShunqiSan, WuyaoShunqiSan for treatment, and it supposed to connecting with emotional lumbago such as hysteria, feigned illness and anxiety psychosis.

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