• 근관절건강학회지
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• 제1권1호
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• pp.71-87
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• 1994

The purpose of this study was to assess pain, discomfort, depression and coping patterns and the relations between these in chronic arthritis patients. The sampling method was a purposive sampling technique. 1) Who have been diagnosed as having chronic arthritis and. 2) Who were at the out patients clinic of rheumatoid arthritis departments of one University hospital in seoul between september, 11, 1993 to september, 18, 1993. The instruments used for this study were Graphic Rating Scales of pain, discomfort level of the activities of daily living(ADL) developed by Lee, Eun Ok and The Beck Depression inventory. The research used to measure coping patterns was a tool developed by the present study researcher. Analysis of data was done frequency, Pearson correlation coefficients, ANOVA, regression and ANCOVA. The results were summerlized as follows ; 1. Female exceed male patients in number and onset of joint pain were more prevalent in the age groups of the 40s and the 50s. The average duration of suffering from the pain were seven years six mounths. 2. The mean pain score : The mean sensory score was 119mm and the affective score was 109mm. 3. The discomfort level of ADL, the mean score was 2.95 out of a possible score of 5.0 and depression syndrome subjects were 62.2%. 4. The coping responses for each pattern were as follows : 1) "Active coping" mean score was 2.28. 2) "Wishful coping" mean score was 2.89. 3) "Receptive coping" mean score was 3.31. 4) "Negative coping" mean score was 1.82. 5. Significant differences were found in age, religion, marriage status and the coping patterns of patients. 1) In the coping pattern of "receptive coping", the score of the age groups of the 50s were higher than that of 20s, and in the coping pattern of "negative coping", the score of the age groups of the 20s were higher than other age groups. 2) In the coping pattern of "wishful coping", the score of the christian were higher than other religion groups. 3) In the coping pattern of "negative coping", the score of the marrieds were lower than other groups. 6. Patients who scored low on factor 2, wishful coping, were much more likely to report having pain sensory than patioets scoring high on this factor. 7. Patients who scored high on factor 4, negative coping, were significantly more likely to report having pain sensory than patients scoring high on this factor. Consider overall, chronic arthritis patients report using a wide varity of strategies, certain strategies such as receptive, wishful and active coping are used frequently, whereas other strategies such as negative coping are rarely used. One of the most important finding of present study is that the reported use of coping strategies is related to adjustment to a chronic pain problem. The present study suggests that negative coping is related to poor emotional adjustment as assessed by depression, but not pain ratings. Considered overall, this pattern of findings suggests that counseling patients to decreased their use of negative coping may be useful. The present study has a number of limitations. First, the sample is restricted to chronic arthritis patients. Weather chronic pain patients suffering from other types of pain syndromes use similar coping strategies needs to be determined in subsequent research. Second, the tool of coping pattern must be studied further to obtain reliability.

• 기본간호학회지
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• 제8권2호
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• pp.210-219
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• 2001

Purpose: To examine the effects of the GEAP on pain, fatigue, self-esteem, perceived health status and self-efficacy in patients with chronic arthritis. Methods: One group Pre- & post-test design was used. Outcome domains included pain, number of painful joints, fatigue, self-esteem, perceived health status and self-efficacy. Thirty-four patients were recruited over four times from a rheumatic clinic affiliated to a university medical center in Seoul, Korea The GEAP is an exercise program modified by the investigators from PACE program which developed by Arthritis Foundation. The program duration is about 60 minutes, three times a week for 6 weeks. Participants were predominantly women (68%) ; on average 57.3 years old; and diagnossed with RA (58.8), osteoarthritis (29.4) or other (11.8). Results: After completing the GEAP, subjects showed significant improvement in pain (p=.02), number of painful joints (P= .04), fatigue (p= .0001), and perceived health status (P=.006). There were no improvements in self-esteem and self-efficacy score for adults with chronic rheumatic diseases. Conclusion: This study showed that the GEAP is an effective exercise intervention for improving outcomes for patients with chronic arthritis. More sample and research are needed to 1) accurately evaluate on self-esteem and self-efficacy; 2) understand and improve adherence. And also a longer follow up period is recommended to evaluate long-term effects of the PACE program.

• 대한근관절건강학회:학술대회논문집
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• 대한근관절건강학회 1997년도 제6회 춘계학술대회
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• pp.134-146
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• 1997

Sixty-nine articles were reviewed to understand the depression in patients with rheumatoid arthritis. Among these articles, forty seven were the studies that dealt with depression in rheumatoid disease, nineteen studied the depression in patients with other chronic disease or in normals, and three were the studies that compared the depression in the patients with rheumatic disease and in the other subjects. Specifically, the articles were analyzed (1) to determine whether the patients with rheumatic arthritis were more depressed than normal population or subjects with other chronic diseases ; (2) to test whether the measurement problems exit ; (3) to identify the disease related, personal, psychologic, and demographic variables to affect the depression and (4) to identify the nursing interventions which improve the depression in rheumatoid arthritis. Based upon these results, some suggestion were made for future research and practice.

• 대한근관절건강학회:학술대회논문집
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• 대한근관절건강학회 2001년도 제14회 총회 및 춘계학술대회
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• pp.179-190
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• 2001

The purpose of this study was to explore the effects of GEAP on pain, joint function, activities of daily living(ADL) and fatigue in chronic arthritis patients. The GEAP was held twice a week for 6 weeks for chronic arthritis patients at one university hospital in Seoul, Korea. Thirty four subjects completed the program, who were recruited at four times from September, 1999 to September, 2000. The effect of GEAP were evaluated as follows: Pain severity and number of painful joints ADL, fatigue were measured before and after the GEAP. In order to examine the joint flexibility and strengthening, the followings were measured: the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion (ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension, and the grip strength. Paired t-test and Wilcoxon signed rank test were used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the GEAP. After the GEAP, followings were found: 1. Pain severity and number of painful joints was significantly decreased. 2. The flexibility of both shoulders and arms, knee, both ankle were significantly improved. 3. The strengthening of both arms was significantly improved, but the strengthening of ankle was not changed. 4. ADL was significantly increased. 5. Fatigue was significantly decreased. In conclusion, GEAP used in this study was clearly proved to be an effective exercise program to reduce pain and fatigue, to enhance joint function and ADL in people with chronic arthritis. It is suggested that the GEAP should be recommended as one of the useful and appropriate nursing interventions for chronic arthritis patients.

• 근관절건강학회지
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• 제6권1호
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• pp.73-84
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• 1999

This study was conducted to identify the characteristics of fatigue and its influencing factors in patients having chronic arthritis. The subjects of this study were 120 patients who visited a Rheumatis Center of H University Hospital. Data were collected from Aug. 9, 1997 to Feb. 5, 1998. For analysing data, SPSS/Win was used for descriptive statistics & Pearson's correlation coefficient, and Lisrel 8.0 was for path analysis. The findings were as follows : 1. Mean score of subjective fatigue was 5.36 and it means moderate degree of fatigue. 2. Fatigue showed positive relationship with pain & depression, and it showed negative relationship with ADL & self efficacy. 3. Fatigue was influenced by pain and depression. and was not influenced by ADL and self efficacy directly. But ADL and self efficacy influenced on fatigue through pain and depression indirectly. According to this findings. the significant influencing factors of fatigue were pain and depression, therefore the development of nursing intervention for relieving pain and depression would be needed.

• 근관절건강학회지
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• 제4권2호
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• pp.249-261
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• 1997

The purpose of this study was to explore the effect of short term selp-help education on pain, depression, self-efficacy, and quality of life in patients having chronic arthritis. This program was carried out 3 hrs per week for 4 weeks by 3 small groups among 10 patients. Research design was a quasi-experimental study of nonequivalent control group pretest-posttest design. The subject of this study were 10 of experimental group and 10 of control group. Before and after 4 weeks program, quality of life, self-efficacy, depression, pain, ADL were measured. As a result, it was confirmed the self-help education was effective to increase quality of life, but self-efficacy, depression, pain, ADL were not improved. This suggests the replicate study to examine the effect of self-help education with the large samples of subjects having chronic arthritis.

• 대한간호학회지
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• 제17권3호
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• pp.218-226
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• 1987

This descriptive-correlational study was undertaken in order to examine if there were relationships between family support, compliance and life satisfaction in chronic arthritis patients. The sampling method was a non-probability, purposive sampling technique. The participants of this study were 92 volunteer adults. 1) who have been diagnosed as having chronic arthritis and 2) who were at the medical out patient clinic of one university hospital in Seoul between April 27th to May 12th 1987. The instruments used for this study were the Family Support Scale developed by Kang Hyun Sook, a Compilance Scale developed by the researcher and the Life-Satisfaction Index-Z developed by Wood et.al. Analysis of data was done using t-test, ANOVA, Pearson Correlation Coefficient and Stepwise Multiple Regression Analysis. The results of study were as follows; Hypothesis I; “The higher the family support, the higher the compliance” was accepted. (r＝.2604, p＜.01) Hypothesis II; “The higher the compliance, the higher the life satisfaction,” was rejected. (r＝.1663, p＞0.5) Hypothesis III; “The higher the family support, the higher the life satisfaction” was accepted. (r＝.3914, p＜.01) In addition, by using Stepwise Multiple Regression Analysis it was determined that the main influencing factors on the life satisfaction were family support, the number of inflammatory joints, compliance and pain level. These 4 main variables made it possible to explain 30.8% of the variance in life satisfaction. In conclusion, this study revealed that family support is an important factor that can improve compliance and life satisfaction in chronic arthritis patients.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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• pp.41-76
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• 2001

Rheumatoid arthritis is an incurable chronic inflammatory and destructive arthopathy that affects 1% of the population world-wide. It has substantial personal, social and economic costs. The long-term prognosis is poor: 80 percent of affected patients will become disabled within 20 years after onset of disease. Medical costs of rheumatoid arthritis average ∼$ 6000 (US) per patient (1), Current antirheumatic drugs have limited efficacy and many side effects and more importantly they do not improve the long-term prognosis of rheumatoid arthritis (2). After a decade of few notable advances in therapy, several biological response modifiers that target pathophysiological processes in the disease have now emerged in the clinic. These new drugs are termed biological agents, and although information about their use in the clinic is still limited to short term treatment, they appear to have the ability to modify disease progress. In addition, COX-2 selective agents have now been approved that have comparable efficacy with standard NSAIDs, but fewer gastrointestinal side effects (3). Thus today many more therapeutic options are suddenly open to patients that even five years ago had little hope of relief from chronic pain and inflammation.

• 대한간호학회지
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• 제27권1호
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• pp.13-25
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• 1997

Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had had it for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their on terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emgerged from the analysis were' Emotional Disturbances', 'Trying to Adapt to the Progress of Disease', 'Progress of Treatment'. 'Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

• 근관절건강학회지
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• 제5권1호
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• pp.72-82
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• 1998

The purpose of this study was to identify functional impairment and psychological status and to analyze their relationships in patients with chronic arthritis. The sample was consisted of 75 arthritic patients who visited H hospital and S welfare center. Functional impairment was measured by ADL, pain, and the number of painful joint. Psychological status was measured by depression, self-efficacy, and quality of life. Data was analyzed by frequency, mean ${\pm} SD$, Pearson's correlation coefficient, and Stepwise multiple regression. The results of this study were as follows : 1. In functional Impairment, ADL was below average which means somewhat difficult, pain was above average, and the number of painful joint was 9.20. 2. In psychological status, scores of quality of life was 97.89, depression was 41.28, self-efficacy was 895.35. 3. Pain was negatively correlated to self-efficacy, ADL and quality of life, and positively correlated to depression. 4. Self efficacy and depression explained 45% of the variance in quality of life. Therefore, it is suggested that nursing intervention improving psychological status would be useful for patients with chronic arthritis. Especially, it is very important to implement nursing intervention focused on increasing self-efficacy and decreasing depression.