• Journal of Hospice and Palliative Care
• /
• v.22 no.2
• /
• pp.67-76
• /
• 2019

For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

• Journal of muscle and joint health
• /
• v.5 no.1
• /
• pp.83-109
• /
• 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.

• Korean Journal of Psychosomatic Medicine
• /
• v.12 no.1
• /
• pp.56-65
• /
• 2004

Objectives: The aim of this study was to investigate the quality of life of caretaking family members who have a patient with psychiatric disorders. The results will be served as a basic data of ameliorating the quality of life of caregivers. Methods: 78 caretaking family members who have a patient with schizophrenia and 54 caretaking family members who have a patient with alcohol dependence, a total of 132 persons completed the questionnaire, and analyzed. The Korean version of the SmithKline Beecham Quality of Life Scale and the Family Burden Scale were applied. Results: There was no statistically significant correlation between burden and sex, age, income, and duration of living with patients before onset. The male caregiver showed higher quality of life than that of female. It showed statistically significant correlation between age and factor physical well-being and factor activity. 41% of variance of quality of life of caregivers were explained by the stress response, burden, and overall merits of the field of psychiatry, and the tension had the most explanatory power. Conclusion: The chronic illness may give a burden on caregivers, and that decrease the quality of life of caregivers. The longer duration of illness of patients, the lower quality of life of caregivers on competence factor. Therefore, the authors recommend the therapeutic modality must be offered to the caregivers who may experience the stress and burden.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.20 no.4
• /
• pp.57-65
• /
• 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.

• The Journal of the Korea Contents Association
• /
• v.18 no.2
• /
• pp.113-123
• /
• 2018

This study was conducted to construct and test a structural equation model of instrumental activities of daily living(IADL) in community-dwelling elderly. The model was based on ICF(International Classification of Functioning, Disability and Health) model. The participants were 260 elderly who were more than 65 years old. Physical and psychological function, visual-motor integration and social activities had direct effects on IADL. That is, the better the subjective health status, the lower the depression and the less chronic illness, the better IADL. Personal factor, social support and social activities had indirect effect on IADL. This model explained 32% of the variance in IADL.

• Journal of the Korean Society of School Health
• /
• v.12 no.2
• /
• pp.243-262
• /
• 1999

Today, obesity is not recognized as a disease itself but is known to be the indirect cause of much chronic illness. Obesity has an impact on psychological disorders including severe inferiority, damage of body self-image, low self-esteem, personality disorders. The results in an increase of the mortality rate. Therefore, this study attempts to discover and evaluate stressful experience in obese teenagers. For this study, 21 girl students and 19 boy students in Pusan middle or high school located were selected. The data were collected from March to May at 1999. A tape-recorder was used under the permission of the subjects to prevent the loss of spoken information and communication. This study consisted of 563 reponses from girls and 461 responses from boys which were then classified with descriptive expressions and priority classifications. The results generated 72 common elements in girls and 54 common elements in boys. From these elements 24 syntheses of hypothetical definitions and 8 identifications of the structural definitions in both girls and boys were developed. The structural and hypothetical definitions were as follows: The analysis of the data was made through a phenomenological analytic method suggested by Van kamm, which is as follows: 1. Maladjustment to school life; lack of understanding of the teacher, insufficient exercise ability, and a feeling of burden in attending the school obesity program. 2. Conflict in family relationships; lack of understanding from the family, a feeling of alienation. 3. Conflict in friend relationships; lack of understanding among friends, constant comparisons in appearance and body with friends (in girls) and estrangement from friends (in boys). 4. Conflict in acquaintance of the opposite sex; hoping to meet the opposite sex, lack of understanding of boy friends (in girls), feelings of pain, feelings of anxiety (in girls) feelings of burden (in girls) feelings of envy (in boys). 5. Negative body image: shape of body; feelings of pain; feelings of powerlessness; feelings of discomfort, and reception; emotional disorders (in boys), and change of personality (in boys). 6. Health disorder: Physical and psychological discomfort. 7. Feelings of burden in weight control; negative experiences in weight control, interference with family and friends, the difficulty in diet therapy, feelings of burden in exercise (in girls), to be teased by the public through mass media (in boys).

• Journal of muscle and joint health
• /
• v.21 no.3
• /
• pp.195-205
• /
• 2014

Purpose: This study was conducted to identify factors that influence health-related quality of life in older adults with osteoarthritis. Methods: This study used a cross-sectional design with secondary analysis of the Korean National Health and Nutrition Examination Survey 2011. A total of 362 participants aged 65 years and older who had osteoarthritis were selected. Health-related quality of life using EQ-5D, perceived health status, body mass index, numbers of chronic illness, smoking and alcohol use, exercise, activity limitation, joint pain and stiffness, depression, and perceived stress were measured. Descriptive statistics, $x^2$-test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression were conducted with SPSS/WIN 21.0. Results: The mean score of EQ-5D was 0.77 in older adults with osteoarthritis. The results of multiple regression analysis showed that age, income, subjective health status, restriction of activity, knee joint stiffness, depressive mood, and perceived stress significantly predicted health-related quality of life in older adults with osteoarthritis, explaining 42% of the variance. Conclusion: Older adults with osteoarthritis have low health-related quality of life. In oder to improve health-related quality of life in older adults with osteoarthritis, it is important not only to enhance physical function but also to provide emotional support.

• The Korean Journal of Rehabilitation Nursing
• /
• v.3 no.1
• /
• pp.108-117
• /
• 2000

Stroke is one of the leading causes of death in Korea. Because of their sequelae, strokes are categorized as a sudden-onset, constant course chronic illness which needs continuous efforts for rehabilitation. Unfortunately, there are few community based rehabilitation program for post-stroke patients who stay at home. The authors developed a community based selp-help management program for post-stroke patients to enhance their rehabilitation process. The program consists of five sessions and each session contains health education. ROM exercise, ADL training, and stress management like foot reflexology. A professor and two graduate students of nursing college coordinated the program. To test the effects of the program we conducted a 5 week program to the 10 conveniently selected post-stroke patients who were living in Kang-buk district of Seoul. The Questionnaires about ADLs, IADLs, depression and life satisfaction were asked to the all subjects before and after program. The hand grisp power and muscle strength of four limbs were measured at the end of each sessions. The analysis of data revealed that the program was effective to increase the ADLs, IADLs, and muscle strength and to decrease the depression levels of subjects. However, there was no significant difference between pre and post hand grisp power and life satisfaction. Because the program was effective to Improve the physical and psycholocial function of subjects, we suggest continual development and Implementation of community based self-help management programs.

• Journal of East-West Nursing Research
• /
• v.10 no.1
• /
• pp.53-60
• /
• 2004

The purpose of this study was to examine the effects of the short term education and reinforcement program to health promotion in women in mid-life. This study has been done between February and April, 2004 and the subjects of the study were 26 women in mid-life. The treatment intervention was applied during total 8 weeks as 5 days for the short term education and 7 weeks for reinforcement with 1 time per a week. The short term education included health education for menopause, effect of exercise, healthy diet, management of stress and management of chronic illness and stretching exercise and recreation. The collected data were processed using the SPSS Win(12.0) program and analyzed using Wilcoxon Signed Ranks Test. The result of this study are as follows : 1. The short term education and reinforcement program significantly effected on the total cholesterol, HDL-cholesterol, triglyceride. 2. The short term education and reinforcement program significantly effected on the anxiety, but not depression. 3. The short term education and reinforcement program non significantly effected on the sleep disturbance and self-efficacy of exercise. 4. The short term education and reinforcement program significantly effected on the practice of healthy life. In conclusion, the short term education and reinforcement program effected on the physical health index, anxiety and practice of healthy life.

• Journal of Hospice and Palliative Care
• /
• v.16 no.3
• /
• pp.175-182
• /
• 2013

Purpose: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. Methods: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. Results: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). Conclusion: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.