• Journal of Yeungnam Medical Science
• /
• v.36 no.1
• /
• pp.1-7
• /
• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• Clinical and Experimental Pediatrics
• /
• v.65 no.5
• /
• pp.222-229
• /
• 2022

Pediatric chronic kidney disease (CKD) is a chronic illness that affects the overall quality of life of patients during childhood. This article highlights the psychological and social burden of CKD in patients and their families. Patients with CKD and their families require comprehensive treatment for psychosocial problems. Therefore, it is crucial for pediatricians to screen for these issues and refer patients and their families for therapy. Tools that are short, easy to administer, and easy to score, such as the Pediatric Quality of Life Inventory or the Childhood Depression Inventory, can be utilized during routine clinical appointments. Reducing the negative impact of CKD on the family will improve the well-being and coping skills of patients and their families.

• Korean Journal of Adult Nursing
• /
• v.20 no.4
• /
• pp.652-663
• /
• 2008

Purpose: This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. Methods: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. Results: The overall fitness indices of modified model were good($x^2$ = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, $x^2$/df = 1.194). Functional capacity was influenced directly by age(${\beta}$ = -.304, p = .000), dyspnea(${\beta}$ = -.278, p = .000), self-efficacy(${\beta}$ = .240, p = .000), social support(${\beta}$ = .175, p = .004), pulmonary function(${\beta}$ = .169, p = .008), and oxygen saturation(${\beta}$ = .099, p = .048). These variables explained 39.3% in functional capacity. Conclusion: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

• Korean Journal of Adult Nursing
• /
• v.14 no.4
• /
• pp.501-509
• /
• 2002

Purpose: This study was performed to identify the illness intrusiveness, quality of life, and their relationships in patients with chronic liver disease. Method: Data was collected using scales of illness intrusiveness developed by Devins et al and Korean health related quality of life (KoQoLS) developed by Shim et al to measure the illness intrusiveness and quality of life from 141 chronic liver disease patients. Result: The total mean score of illness intrusiveness was $38.85{\pm}18.45$. The domain of illness intrusiveness which showed the highest mean score was health ($4.60{\pm}2.02$), and the lowest mean score domain was relationship with spouse ($20.4{\pm}1.69$). The subcategory of KoQoLS which showed the highest mean score was bodily pain ($6.96{\pm}2.98$), and the lowest mean score subcategory was vitality ($2.75{\pm}1.20$). There were negative relationships between illness intrusiveness and KoQoLS in all subcategories. Abovel all, Illness intrusiveness had the strongest negative relationship with role limitation (r=-0.641) among the KoQoLS subcategories. Conclusion: Because the illness intrusiveness had negative influence on the quality of life in patients with chronic liver disease, further research will need to specify detailed illness intrusiveness and to explore influencing factors on quality of life in them.

• Journal of Korean Academy of Nursing
• /
• v.32 no.1
• /
• pp.62-76
• /
• 2002

This study was designed to construct a structural model for health promoting behavior of patients with chronic disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. Method: Data was collected by questionnaires from 1748 patients with chronic disease in General Hospital from December 1999 to July 2000 in Seoul. The disease of subject were cardiac disease included hypertension peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. Results: 1. The fit of the hypothetical model to the data was moderate, it was modified by excluding 4 path and including free parameters to it. The modified model with path showed a good fitness to the empirical data (χ2=591.83, p<.0001, GFI=0.97, AGFI= 0.94, NNFI=0.95, RMSR=0.01, RMSEA=0.05). 2. The perceived benefits, perceived barriers, self-efficacy, self- esteem, and the plan for action were found to have significant direct effect on health promoting behavior of chronic disease. 3. The health concept, health perception, emotional state, social support were found to have indirect effects on health promoting behavior of chronic disease. Conclusion: The derived model in this study is considered appropriate in explaining and predicting health promoting behavior of patients with chronic disease. Therefore, it can effectively be used as a reference model for further studies and suggested implication in nursing practice.

• Journal of Nutrition and Health
• /
• v.41 no.4
• /
• pp.307-316
• /
• 2008

The purpose of the study was to investigate nutritional status of chronic obstructive pulmonary disease (COPD) patients and to find out the differences according to the stages of disease. From March to October, 2006, 41 stable male patients of mild to severe COPD patients were recruited from Seoul National University hospital. The patients' of body weight and fat free mass were assessed by bioelectrical impedance analysis. The nutritional status of the patients was also assessed by 3-day recall, index of nutritional quality (INQ), dietary diversity score (DDS), dietary variety score (DVS), food group index pattern and dietary quality index (DQI). The total of 41 patients were classified into three groups, stage I, stage II and stage III groups according to the classification of Global Initiative for Chronic Obstructive Lung Disease (GOLD) standard. The mean age of the patients in each stage were 67.2-66.9 years showing no significant difference. The ratio of $FEV_1$/FVC were $57.5{\pm}7.3$, $46.9{\pm}7.6$ and $38.2{\pm}6.8%$, respectively showing significant differences according to the stages of disease. The fat free mass of the stage II ($48.2{\pm}4.7kg$) and III ($47.3{\pm}4.5kg$) was significantly lower than that of stage I ($53.1{\pm}6.9kg$) patients. There were significant correlation of fat free mass with $FEV_{1}$, and BMI (body mass index) with $FEV_{1}$/FVC ratio (p < 0.05). COPD patients showed the diet-related clinical symptoms of anorexia, dyspnea, dyspepsia, and chewing difficulty. Daily intakes of calorie, K, vitamin $B_2$ and folate of the patients were very low ($83.8{\pm}20.7%$, $58.9{\pm}14.4%$, $70.7{\pm}19.6%$ and $74.4{\pm}10.2%$, respectively) however, they did not significantly different according to the stages of disease. Daily intake of calcium was significantly lower in the stage III patients (p < 0.05). The mean scores of dietary variety score was significantly lower in the stage III patients (p < 0.001). Dietary quality index of the patients were not different among the stages of disease and the scores indicated poor quality of diet. As a summary, we found that body fat free mass, regularity of exercise, frequency of having snacks and dietary variety score were significantly associated with the severity of chronic obstructive pulmonary disease.

• Journal of Korean Biological Nursing Science
• /
• v.12 no.2
• /
• pp.114-126
• /
• 2010

Purpose: To examine the levels of the disease-related knowledge and educational demands of pre-dialysis, chronic renal failure patients at different GFRs and stages. Methods: This study used a cross-sectional survey and aimed at 116 pre-dialysis, chronic renal failure patients, who were registered and received regular treatment from December 1 to December 31, 2009 at the nephrology departments of tertiary medical centers in Seoul. Stages were classified into Stage 3, 4 and 5 depending on GFR ranges. To measure the levels of knowledge and educational demands, the tool, which were first invented by Young Ae Lim (1996) and then modified by Hyo Sun Lim (2005) to adjust the knowledge and educational demands measuring tool for hemodialysis patients to pre-dialysis patients with chronic renal failure, was used. Collected data was analyzed with the SPSS WIN 12.0 program (average, standard deviation, Pearson's correlation coefficient, t-test and ANOVA). Results: There was a significant difference in the disease-related knowledge levels of the subjects at each stage (F=24.41, p=.000). The Scheffe post hoc test confirmed that patients at higher stages had higher levels of knowledge of their disease. Also, although the results showed that patients at higher stages had higher educational demands, there was no significant difference among the groups (F=1.259, p=.288). Conclusion: As patients have different levels of knowledge of the disease and educational demands depending on their stages, it is important to develop and use a systematic education program that reflects the demands and levels of patients at each stage in order to help pre-dialysis patients with chronic renal failure with self-management and improve their quality of life.

• Korean Journal of Psychosomatic Medicine
• /
• v.6 no.1
• /
• pp.35-45
• /
• 1998

Objectives : The purpose of this study was to determine correlation between coping strategies to disease and quality of life in chrome viral B hepatitis patients ; to investigate difference of coping strategies to disease and quality in life between chronic viral B hepatitis patients and normal persons ; and to identify major variables related to quality in life of chronic viral B hepatitis patients. Methods: The authors used Weisman coping strategy scale for measuring coping ability and efficacies, and the questionnaire for measuring quality of life including physical, psychological, social and economical aspects and satisfaction of sexual life was made by authors based on related literatures. Data were collected through questionnaire survey over a period from Sep 15, 1994 to Nov 11, 1994. Subjects served for this study consisted of 94 chronic viral B hepatitis patients visited to department of internal medicine at one general hospital and 100 normal persons visited to one general hospital for routine check up of health. The collected data were analyzed by SAS and the statistical methods for analysis were Chisquare, t-test and multiple regression analysis. Results : 1) It was revealed that coping strategies to disease significantly correlated to individual's quality of life. 2) There was no significant difference in coping strategies to disease between chronic viral B hepatitis patients and normal persons. However, chronic viral B hepatitis patients showed the lower scroes of quality of life in physical, psychological and economical aspects. 3) The most important variables which were influenced upon quality of life were coping strategies to disease and satisfaction of sexual life. That is, the more active coping strategies to diseases and the higher satisfaction of sexual life, consequently the higher quality of life was. Especially male patient group or normal persons showed each other the higher scores of quality of life in physical and psychological area than female group or patient group. 4) No statistically significant difference in coping strategies to disease and quality of life was found between HBeAg positive group and HBeAg negative group. Conclusions : The authors suggest that chronic viral B hepatitis patients may show the lower score of quality of life than normal person. Therefore, quality of life assessment should become an integral part of all clinical area that seek to assess the effectiveness of treatment. Also, through the interdisciplinary approach, a comprehensive paradigm that can better account for the effects of chronic disease on the individual' s quality of life should be developed.

• Tuberculosis and Respiratory Diseases
• /
• v.86 no.2
• /
• pp.71-81
• /
• 2023

Chronic obstructive pulmonary disease (COPD) affects close to 400 million people worldwide. COPD is characterized by significant airflow limitation on spirometry. Most patients with COPD are diagnosed in their fifth or sixth decades of life. However, the disease begins much earlier. By the time airflow limitation is detected on spirometry, patients with COPD have lost close to 50% of their small airways. Thus, identification of patients with early COPD, defined as persons with preserved spirometry, who demonstrate pathologic or functional hallmarks of COPD, is essential for disease modification and ultimately disease elimination. This paper provides an up-to-date overview of the current case definition of early COPD, its importance, the novel technologies required for its detection in young adults and future directions in therapeutics for treatment.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.2
• /
• pp.122-136
• /
• 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.