• 한국노년학
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• 제39권4호
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• pp.941-958
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• 2019

본 연구는 중·장년기 주관적 건강상태의 변화궤적 유형을 탐색적 차원에서 확인하고, 도출된 주관적 건강상태 변화궤적 유형과 사회경제적 요인, 개인 내적 요인, 가족관계 요인의 관계를 검증하여 중·장년기의 건강한 노후를 맞이하는 방안을 모색하는데 목적을 두고 있다. 이를 위해 한국복지패널 2~12차(2007년~2017년)의 종단자료를 활용하여 중·장년기 2,418명을 최종 분석대상으로 삼았다. 연구방법으로는 주관적 건강상태의 변화궤적 유형을 확인하기 위하여 잠재계층성장분석을 적용하였으며, 건강상태에 있어 안정집단과 위험집단을 예측하는 요인을 검증하기 위하여 다항 로지스틱 회귀분석을 실시하였다. 연구결과, '고수준-유지형(46.3%)', '저수준-유지형(19.6%)', '감소형(17.5%)', '증가형(16.6%)'의 4가지 유형이 확인되었다. 건강상태와 밀접한 요인인 만성질환 변화를 통제하였음에도, 지속해서 경제활동을 할수록 '저수준-유지형'보다'고수준-유지형'에 속하는 것으로 나타났다. 또한, 자아존중감이 높아질수록 '감소형' 보다 '고수준-유지형'에 속하고, 가족관계에 대한 만족이 증가할수록 '저수준-유지형' 보다 '고수준-유지형'으로, 가족 스트레스를 덜 받을수록 '저수준-유지형'보다 '증가형'에 속하게 되는 것으로 나타났다. 본 연구를 바탕으로 중·장년의 건강을 지속해서 관리할 수 있도록 돕는 국가 체계의 정책적 제언과 현장 중심의 실천적 제언을 제시하였다.

• Nutrition Research and Practice
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• 제17권5호
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• pp.899-916
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• 2023

BACKGROUND/OBJECTIVES: Oxidative stress is a fundamental neurodegenerative disease trigger that damages and decimates nerve cells. Neurodegenerative diseases are chronic central nervous system disorders that progress and result from neuronal degradation and loss. Recent studies have extensively focused on neurodegenerative disease treatment and prevention using dietary compounds. Heseperetin is an aglycone hesperidin form with various physiological activities, such as anti-inflammation, antioxidant, and antitumor. However, few studies have considered hesperetin's neuroprotective effects and mechanisms; thus, our study investigated this in hydrogen peroxide (H₂O₂)-treated SH-SY5Y cells. MATERIALS/METHODS: SH-SY5Y cells were treated with H₂O₂ (400 µM) in hesperetin absence or presence (10-40 µM) for 24 h. Three-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assays detected cell viability, and 4',6-diamidino-2-phenylindole staining allowed us to observe nuclear morphology changes such as chromatin condensation and apoptotic nuclei. Reactive oxygen species (ROS) detection assays measured intracellular ROS production; Griess reaction assays assessed nitric oxide (NO) production. Western blotting and quantitative polymerase chain reactions quantified corresponding mRNA and proteins. RESULTS: Subsequent experiments utilized various non-toxic hesperetin concentrations, establishing that hesperetin notably decreased intracellular ROS and NO production in H₂O₂-treated SH-SY5Y cells (P < 0.05). Furthermore, hesperetin inhibited H₂O₂-induced inflammation-related gene expression, including interluekin-6, tumor necrosis factor-α, and nuclear factor kappa B (NF-κB) p65 activation. In addition, hesperetin inhibited NF-κB translocation into H₂O₂-treated SH-SY5Y cell nuclei and suppressed mitogen-activated protein kinase protein expression, an essential apoptotic cell death regulator. Various apoptosis hallmarks, including shrinkage and nuclear condensation in H₂O₂-treated cells, were suppressed dose-dependently. Additionally, hesperetin treatment down-regulated Bax/Bcl-2 expression ratios and activated AMP-activated protein kinase-mammalian target of rapamycin autophagy pathways. CONCLUSION: These results substantiate that hesperetin activates autophagy and inhibits apoptosis and inflammation. Hesperetin is a potentially potent dietary agent that reduces neurodegenerative disease onset, progression, and prevention.

• 생명과학회지
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• 제34권1호
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• pp.9-17
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• 2024

제 2형 당뇨병에서 나타나는 인슐린 분비 감소는 베타세포의 자가사멸에 의한 베타세포질량의 급격한 감소로 인한 것으로 보고되고 있으며, 베타세포의 자가사멸을 촉진하는 요인으로 고혈당에 의한 당독성 및 활성산소종들의 증강에 의한 산화스트레스 등이다. Ferulic acid는 항산화, 항염, 항암 등 다양한 생리활성을 나타내며, 본 연구에서는 고혈당으로 유도된 세포 당독성 개선 효과와 그 기전을 INS-1 췌장 베타세포에서 규명하고자 하였다. Ferulic acid는 고농도 포도당 처리된 INS-1 췌장 베타 세포에서 세포 생존율을 증가시키고, 지질과산화물, 세포 내 ROS 및 NO 수준을 감소시켰다. 세포사멸 관련 인자의 유전자 발현결과 pro-세포자가사멸 인자인 bax, cytochrome c, caspase-3 및 caspase-9의 단백질 발현을 유의적으로 감소시켰고, anti-세포자가사멸 인자인 bcl-2 발현을 증가시켰다. Ferulic acid는 annexin V/I propidium iodide 분석을 통하여 고농도 포도당으로 유도된 세포 사멸을 감소시키고, INS-1 췌장 베타세포에서의 인슐린 분비능을 증가시키는 것으로 사료된다. 따라서ferulic acid는 고농도 포도당으로 손상된 INS-1 췌장 베타세포의 보호효과를 나타낸다.

• Tuberculosis and Respiratory Diseases
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• 제59권2호
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• pp.142-150
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• 2005

연구배경 : Peroxiredoxin (Prx) 은 최근에 알려진 항산화제로 세포의 증식과 분화, 세포사멸이나 발암과정에 관여하는 것으로 알려져 있다. 하지만, 현재까지 폐암을 비롯한 각종 질병에서의 이들 Prx단백의 역할은 잘 규명되어 있지 않다. 이에 본 연구는 폐암 조직과 정상폐조직에서 Prx 단백의 발현 양상과 분포를 연구하여 이들의 병태 생리학적인 의미를 찾아보고자 하였다. 방 법 : 아주대학교 병원에서 폐암으로 진단된 환자의 폐암조직과, 동일 환자의 정상 폐조직에서, 1 차원전기영동 (reducing 조건과 non-reducing 조건에서의 SDSPAGE) 혹은 2차원전기영동을 시행한 후 Western blot으로 Prx, Trx 및 TR의 발현 양상을 분석 하였으며, 백서의 정상 폐조직과, 환자의 폐암 조직에서 anti-Prx rabbit polyclonal 항체로 하여 면역조직화학염색법을 통해, Prx 단백의 분포를 관찰하였다. 결 과 : 면역조직화학염색법 결과 백서의 정상 폐조직에서는 Prx I, II, III 및 V 유형이, 주로 기관지상피세포, 폐포상피세포 및 폐포대식세포에서 발현되고 있음을 관찰하였다. 인체 폐암조직에서는, 정상 폐조직 부위에 비해서 Prx I 과 Prx III 유형 및 Trx단백의 발현이 선택적으로 증가되어 있고, 특히, 2차원 전기영동을 통한 프로티옴 분석에서 산화된 형태의 Prx I 과 Prx II가 증가 한 것을 비롯하여, 분자량과 등전점(pI)이 약간 변화된 형태의 Prx III가 폐암조직에 존재함을 알 수 있었다. 한편, 폐암 조직의 non-reducing 전기영동 후 Western blot에서는, monomer와 dimer 사이의 중간 크기에 해당하는 약 40 kDa과 200 kDa 이상 크기의, 항 Prx 항체와 반응하는 단백 띠 (reactive bands)가 관찰되었다. 결 론 : 폐암 조직에서 관찰되는 Prx I 과 Prx III 유형 및 Trx의 과발현 양상은, 종양 세포들이 주변의 미세 환경으로부터 겪는 여러 스트레스에 대하여 단백질을 보호하고 세포의 생명력을 유지하는데 있어 주요한 역할을 하는 것으로 사료된다.

• Asian-Australasian Journal of Animal Sciences
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• 제13권11호
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• pp.1619-1637
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• 2000

A review was undertaken to obtain information on the range of beak-trimming methods available or under development. Beak-trimming of commercial layer replacement pullets is a common yet critical management tool that can affect the performance for the life of the flock. The most obvious advantage of beak-trimming is a reduction in cannibalism although the extent of the reduction in cannibalism depends on the strain, season, and type of housing, flock health and other factors. Beak-trimming also improves feed conversion by reducing food wastage. A further advantage of beak-trimming is a reduction in the chronic stress associated with dominance interactions in the flock. Beak-trimming of birds at 7-10 days is favoured by Industry but research over last 10 years has shown that beak-trimming at day-old causes the least stress on birds and efforts are needed to encourage Industry to adopt the practice of beak-trimming birds at day-old. Proper beak-trimming can result in greatly improved layer performance but improper beak-trimming can ruin an other wise good flock of hens. Re-trimming is practiced in most flocks, although there are some flocks that only need one trimming. Given the continuing welfare scrutiny of using a hot blade to cut the beak, attempts have been made to develop more welfare friendly methods of beak-trimming. Despite the developments in design of hot blade beak-trimmers the process has remained largely unchanged. That is, a red-hot blade cuts and cauterises the beak. The variables in the process are blade temperature, cauterisation time, operator ability, severity of trimming, age of trimming, strain of bird and beak length. This method of beak-trimming is still overwhelmingly favoured in Industry and there appears to be no other alternative procedures that are more effective. Sharp secateurs have been used trim the upper beak of both layers and turkeys. Bleeding from the upper mandible ceases shortly after the operation, and despite the regrowth of the beak a reduction of cannibalism has been reported. Very few differences have been noted between behaviour and production of the hot blade and cold blade cut chickens. This method has not been used on a large scale in Industry. There are anecdotal reports of cannibalism outbreaks in birds with regrown beaks. A robotic beak-trimming machine was developed in France, which permitted simultaneous, automated beak-trimming and vaccination of day-old chicks of up to 4,500 chickens per hour. Use of the machine was not successful because if the chicks were not loaded correctly they could drop off the line, receive excessive beak-trimming or very light trimming. Robotic beak-trimming was not effective if there was a variation in the weight or size of chickens. Capsaicin can cause degeneration of sensory nerves in mammals and decreases the rate of beak regrowth by its action on the sensory nerves. Capsaicin is a cheap, non-toxic substance that can be readily applied at the time of less severe beak-trimming. It suffers the disadvantage of causing an extreme burning sensation in operators who come in contact with the substance during its application to the bird. Methods of applying the substance to minimise the risk to operators of coming in contact with capsaicin need to be explored. A method was reported which cuts the beaks with a laser beam in day-old chickens. No details were provided on the type of laser used, or the severity of beak-trimming, but by 16 weeks the beaks of laser trimmed birds resembled the untrimmed beaks, but without the bill tip. Feather pecking and cannibalism during the laying period were highest among the laser trimmed hens. Currently laser machines are available that are transportable and research to investigate the effectiveness of beak-trimming using ablasive and coagulative lasers used in human medicine should be explored. Liquid nitrogen was used to declaw emu toes but was not effective. There was regrowth of the claws and the time and cost involved in the procedure limit the potential of using this process to beak-trim birds.

• 정신신체의학
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• 제13권1호
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• pp.16-23
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• 2005

연구목적 : 장기적인 탈모증의 심리적 영향에 대해 알아보기 위해 탈모증을 겪는 여성 환자에서의 불안, 우울, 감정 표현불능증, 성격 특성에 대해서 알아보았으며, 더불어 유전적 생물학적 원인이 크게 작용하는 안드로겐성 탈모증과 정신적 스트레스의 병인론적 역할에 대한 논란이 있는 원형 탈모증간에 심리적 특성에서 차이가 있는지 알아보았다. 방법: 여성 탈모증 환자를 대상으로 최소 1년 이상 치료를 받고 있는 원형탈모증 환자군(52명)과 안드로겐성 탈모증 환자군(33명), 그리고 정상대조군(54명)에서 다면적 인성검사(MMPI), 벡 우울척도(BDI), 상태불안척도(STAI-S), 특성불안척도(STAI-T), 토론토 감정표현불능증척도(TAS-20K)를 시행하여 각 군간의 차이를 비교 분석하였다. 결과: MMPI 결과는 F척도, Hs척도, D척도, Pd척도, Pa척도, Sc척도, Si척도에서 탈모증 환자군이 정상대조군보다 통계적으로 유의하게 높았고, Hy척도, Pt척도는 안드로겐성 탈모증 환자군에서 가장 높았다. BDI 점수, 상태불안척도, 특성불안척도에서 정상대조군에 비해 원형 탈모증과 안드로겐성 탈모증에서 점수가 높았으며, 특히 BDI 점수에서는 심한 우울증(23점 기준)에 해당하는 경우가 원형 탈모증 환자에서 94.2%(49명), 안드로겐 탈모증 환자의 97.0% (32명)로 나타났다. TAS-20K의 경우 총점에서는 환자군이 정상 대조군에 비해 유의하게 높았으며, Factor 3에서 안드로겐성 탈모증이 타 군에 비해 유의하게 높은 점수를 보였다. 또한 STAI-S 및 STAI-T에서도 환자군이 정상대조군에 비해 유의하게 높은 점수를 보였다. 결론: 여성 만성 탈모증 환자에서 우울감이 두드러지고 불안 수준이 높으며 감정표현불능증의 정도가 더 심한 것으로 나타났다. 특히 이러한 결과는 탈모의 병인론에 관련된 논란에도 불구하고, 두 종류의 탈모증에서 거의 모든 환자가 가지는 우울감에 대해서 적극적인 정신과적 개입이 필요하며, 환자의 성격적 측면과 심리적 대처기 전을 고려해야 함을 의미한다.

• 한국직업건강간호학회지
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• 제6권1호
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• pp.23-43
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• 1997

The work-related diseases due to continuous overwork are mainly cerebro- and cardio-vascular ones, which is commonly called 'Karoshi', death from overwork. Many factors are capable for Karoshi : occupational stress in relation to technological renovation and industrial rationalization, competitive social structure, and accumulated fatigue accured to long time or irregular working. And its occurence is on the rise. The World Labor Report 1993 released by ILO, pointed out the diseases related to overwork and stress as one of the most important occupational health problem. In Korea, social awareness of Karoshi is at an infant stage, and reliable statistics for its occurence are not compiled in a convenient manner. Despite the rising Karoshi, there are no reliable clauses in workmen's compensation enough to settle down the disputes. Therefore, it is not uncommon that the Labour Ministry and Civil Court find difficulties in reaching an agreement. This study was intended to provide proper compensation and prevention program for workers by suggesting reasonable compensation clauses for the death from overwork. This study consists of two comparative reviews on the compensaton clauses for the death from overwork. One is to review legal standards of Karoshi among three countries, such as Korea, Japan and Taiwan. The other is to investigate the cases of Karoshi in Korea, 121 cases identified at the Labor Welfare Corperation and the Labour Ministrial process of examination and reexamination, and 73 leading cases at the High Court of Justice. The main findings of the study are as follows : 1. Comparisons of comperative review on compensation clauses for the death from overwork among three countries. 1) All of three countries have the same kinds of disease for compensation, which were cerebro-and cardiao-vascular diseases, while for cardiac disease group, Korea has the smaller number of diseases for compensation than Japan. 2) As for the definition of overwork, the three countries share equally that overload for one week prior to collapse is considered as an important factor, but accumulated chronic fatigue is disregarded. 3) As the basis of overwork, in Japan, there is a tendency to move from the conditions of an ordinary healthy adult to those of the individual concerned in Japan, whereas there is no such concern yet in Korea. 4) All the three countries use a common standard of medical judgement in demonstrating causal relationship between a job and a disease. However, Korea is progressive in the sense that in the case of CVA at worksite, the worker himself has no obligation to prove the cause. 2. The results of a comparative review on excutive decisions by Labor Ministry and judicial decisions by the Court in Korea : A judicial decision is based on the legalistic probability, but a excutive decision is not. Therefore, excutive decisions have such restrictions that : 1) TIA (transitory ischemic cerebral attack) and myocarditis are excluded from compensation, and there is little consistency of decision in the case of cause-unknown death. 2) There is a tendency not to compensate for the death from overwork since the work terms such as repeated long-time working, shift work or night-shift work are not considered as overloading. 3) There is a tendency to regard the conditions of a ordinary healthy adult rather than those of the individual concerned(age, existing diseases, health state, etc.) as the comparative basis of overload. 4) There remains a tendency not to compensate for the death from overwork in the case of collapse occuring out of workplace, on the ground of 'on the course of working' and 'in the cause of accident'. Through the study, the fact manifests itself that Korea's compensation clauses for work-related diseases due to overwork are very restrictive. So, it is necessary to extend the Labor Ministry's clauses of compensation for the death from overwork following to the recent changes of other countries and internal judicial decisions. This is very important in the perspective of occupational health that aims at health promotion of workers including prevention of the Karoshi.

• 한국산림과학회지
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• 제83권3호
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• pp.410-423
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• 1994

지속적인 수분 stress 또는 ABA 처리에 따른 주요 경제 수종들의 생리생태학적 수분특성을 밝히기 위하여 생육기 및 일중 측정 시간대 별 기공증산저항과 증산율을 조사하였다. 졸참나무, 신갈나무, 상수리나무, 굴참나무를 포함하는 4종의 참나무류가 시험재료로 이용되었으며 물푸레나무 또한 참나무류와 함께 분석되었다. 건, 습 두가지의 토양 수분 조건으로 처리된 1년생 실생 용기묘를 대상으로 Li-Cor사의 LI-1600 Porometer를 이용하여 6, 8, 9월에 기공증산저항을 반복 측정하였다. 기공의 움직임과 증산에 미치는 ABA의 효과를 알아보기 위해 7월에 0.5mM, 8월에 0.05mM의 ABA 용액을 용기 실생묘에서 절단한 줄기에 흡수시켰다. 대부분의 기공증산저항 측정치는 처리 종류에 관계없이 일출 후 오전에 약 5s/cm에 머물렀다. 그러나 그 값들은 건조구에 속한 묘목에서 오후 중에 자주 20s/cm 이상의 높은 수준으로 변동했다. 여러 가지 처리 및 환경 조건에 관계없이 굴참나무의 기공증산저항은 졸참나무 또는 상수리나무의 경우보다 안정된 값을 보였다. 물푸레나무의 측정치들은 참나무류에 비해 더욱 불규칙한 변화를 보였다. 묘목 절단지에 흡수된 ABA 용액은 대부분의 대상 수종에서 기공증산저항을 증가시켰다. ABA 처리에 대한 기공의 반응은 7월에 굴참나무 및 상수리나무에 비해 졸참나무에서 보다 예민하게 나타났다. 그러나 8월에는 ABA 처리의 영향이 상수리나무에서 보다 크게 나타났다. 물푸레나무에서 ABA에 대한 반응은 다양한 변화 양상 때문에 분명하지 않았다.

• 생명과학회지
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• 제24권12호
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• pp.1371-1377
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• 2014

활성산소종(ROS)은 환경 스트레스 및 병원체의 침입에 의한 산화 대사의 자연적인 산물로써 생물에서 생산된다. 산화적 스트레스에 의해 생성되는 superoxide 음이온 및 과산화수소와 같은 ROS는 세포와 조직에 독성을 나타낼 수 있고, 이 과정에 관여하는 superoxide dismutase (SOD)는 중요한 metalloenzyme이다. 최근 연구는 올리브 넙치(Paralichthys olivaceus)에서 SOD의 부분 유전자가 benzo[a]pyrene에 의해 강하게 발현이 유도되고 산화 스트레스 반응의 지표라고 확인하였지만, 바이러스성 감염에 대한 전사적 반응에 대해서는 조사되지 않았다. 본 연구에서는 항바이러스 반응에서 넙치 SOD의 기능을 알아보기 위해 공간 및 시간적 발현 프로파일을 분석하였다. 넙치 SOD 전사체는 정도의 차이는 있지만 다양한 기관에서 보편적으로 발현되었으며, 근육, 간, 뇌에서는 높게 발현되었고, 위와 비장에서는 상대적으로 낮게 발현되었다. VHSV 감염 후 넙치 콩팥에서 SOD 발현은 3시간 이내에 증가하였으며 점차적으로 감소하여 감염 2일째 원래 수준으로 돌아갔다. 검사 조직에 따라 발현이 유도되는 시간의 차이는 있지만 근육, 간, 뇌에서도 콩팥과 유사한 발현양상을 보였으며, 공통적으로 급성적 면역반응에서는 발현이 증가하지만 만성적 면역반응에서는 감소하였다. 이상의 결과들을 종합해 볼 때, 넙치 SOD는 넙치(P. olivaceus)의 면역 방어 시스템에 중요한 역할을 하고 넙치의 산화 스트레스에 대한 보호 효과에 기여할 것으로 기대할 수 있다.

• 대한간호학회지
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• 제20권1호
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• pp.88-117
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• 1990

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.