• Journal of Korean Academy of Nursing
• /
• v.29 no.4
• /
• pp.855-869
• /
• 1999

The purpose of this study was to test the effectiveness of self-management relaxation training through biofeedback and progressive muscle relaxation methods. The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS), the McNair's profile of Mood States (POMS), the levels of ephinephrine, norepinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were sixty six nursing students divided into four groups : two groups were the biofeedback and progressive muscle relaxation groups, the other two groups served as control groups. One was a group of sophomores with no experience at all, the other a junior group without self -management or relaxation training. This study was conducted for eight weeks of clinical practice from April, 26th 1998 to June, 20th 1998. Biofeedback training was done with software developed by J&J company (1-410 form for abdominal respiration training). Progressive muscle relaxation training was done with u audiotape recorded according to Jacobson's Theory. The data were analyzed with frequencies, means, and analysis of covariance using the SPSS program and the significance level of statistics was 5%. The results of the study are : 1) The importance of clinical practice stress reduction is shown in that the level of symptoms of stress in the experimental groups in clinical practice was higher than in the group receiving only a lecture. 2) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing the symptoms of stress under the clinical practice stress conditions. 3) The effectiveness of the biofeedback training relaxation method to reduce symptoms of stress was higher than that of progressive muscle relaxation. 4) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in reducing stressful mood states. 5) The relaxation training methods of biofeedback and progressive muscle relaxation were not effective in reducing epinephrine and norepinephrine levels. 6) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in increaing the number of natural killer cells. 7) The relaxation training methods of biofeedback and progressive muscle relaxation were effective in decreasing high systolic and diastolic values of blood pressure and high pulse rates. In summary, the relaxation methods of biofeedback and progressive muscle relaxation in reducing clinical practice stress were effective in lowering the level of symptoms of stress and the profile of stressful mood states. They were also effective in lowering high blood pressure and pulse rates. The relaxation methods were effective in increasing the number of natural killer cells as part of the immune function. However, relaxation methods were not effective in reducing the catecholamine level. The biofeedback training method for reduction of symptoms of stress was more effective than the progressive muscle relaxation method.

• Korean Journal of Radiology
• /
• v.24 no.12
• /
• pp.1249-1259
• /
• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.3
• /
• pp.151-158
• /
• 2015

Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.7 no.1
• /
• pp.109-121
• /
• 2000

Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

• Korean Journal of Acupuncture
• /
• v.30 no.3
• /
• pp.151-160
• /
• 2013

Objectives : The purpose of this study is to review the thread embedding treatment studies of obesity in Traditional Chinese Medicine. Methods : We reviewed 59 studies on cat-gut-embedding treatment of obesity which were published from 2005 to 2012. The studies were searched using the data base-CAJ(China Academic Journals; 中國期刊全文數據庫)(2005~2012). Results : Selected 59 studies were divided into 27 case series and 32 control studies. The number of studies has increased since 2005, more rapidly in 2011~2012. Most case series reported were about effectiveness of thread embedding monotherapy treating obesity. Control studies reported were about effectiveness of thread embedding treatment compared with acupuncture, electroacupuncture, and medicine. Most studies on thread embedding treatment of obesity showed that its effectiveness was very good. Conclusions : There have been many reports of thread embedding treatment studies of obesity in Traditional Chinese Medicine. We believed that these studies could be applied to the clinical practice and basic research in Korea.

• Journal of Acupuncture Research
• /
• v.17 no.3
• /
• pp.99-105
• /
• 2000

Objectives : 19 patients diagnosed with chronic paranasal sinitis among the patients who visited to Kyunghee University Oriental Medical Center Department of Acupuncture and moxibustion from July, 1999 through July, 2000. Methods : The needle used in the treatment was 16cm in length and 0.375mm in radius. Using the straight needling method the choana was acupunctured straightly, and the opening of maxcillary sinus was acupunctured obliquely with the oblique needling method. Resuits : Looking at the effectiveness of this nasal acupuncture treatment, excellent was found in 4 cases(21%), good in 13 cases(68.4%), and unchanged in 2 cases(10.5%). The effectiveness totals up to 17 cases (89.4%) which is considerably high. Conclusions : Nasal acupuncture treatment can be used with high effectiveness in treatment of the chronic paranasal sinitis.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.7 no.1
• /
• pp.54-67
• /
• 2001

This study was tried to investigate the effectiveness of assertive training on the state anxiety and assertive behavior which nursing students had experienced during clinical practice training from April 29, to June 5, 2000. Subjects for this study were thirty-six nursing students of practicing in a general hospital. Eighteen nursing students were assigned for the experimental group and trained by assertive training program during 4 weeks and eighteen nursing students were assigned for the control group. The assertive training program was composed of cognitive, behavioral and emotional assertive training. Post- test assessment was administrated to all subjects on a week later after the last session. The data were analyzed with SPSS PC programs. The results of this study were summarized as follows: 1) There were no significant differences between the experimental group and the control group on post- intervention comparisons of the state anxiety score (p=0.230), but in the experimental group, the anxiety score more decreased after the assertive training than that in the control group with significant differences(p=0.019). 2) There were no significant differences between the experimental group and the control group on post- intervention comparisons of assertive behavior (p=0.530). However, after the assertive training, the experimental group became more assertive than the control group with no significant differences(p=0.721). 3) The hypothesis that the more the assertive behavior, the less the state anxiety experienced by nursing students of clinical practice training was supported(r=-0.397, p=0.017). On the basis of this study results, the assertive training is effective for the reduction of the state anxiety experienced by nursing students of clinical practice training.

• The Journal of Pediatrics of Korean Medicine
• /
• v.34 no.1
• /
• pp.1-25
• /
• 2020

Objectives The purpose of this study is to identify the research trends and to evaluate the effectiveness and safety of Korean medicine treatment by analyzing the recently published clinical studies of Korean medicine treatment on nocturnal enuresis in children. Methods The literatures were searched from OASIS, KISS, NDSL, RISS, Cochrane, CINAHL, Embase, Pubmed, and only clinical studies published from 2000 to October 2019 were included. The publication year, study type, type of enuresis, demographic information of participants, duration of illness, intervention type and details, follow-up period, outcome measurements and adverse events of selected literatures were analyzed. Results A total of 38 studies were selected. In the selected studies, acupuncture was the most frequently used treatment for nocturnal enuresis, followed by herbal medicine, electrical stimulation treatment, moxibustion, acupressure and plaster therapy. The most commonly used acupoints for acupuncture were SP6 and CV4, and the most used herbal medicine was Chukcheonwhan, while Alpiniae Fructus (益智仁) and Dioscoreae Rhizoma (山藥) were the most used herbal materials. Most of the studies showed that the total effective rate of Korean medicine treatment was high. All the adverse events occurred in the Korean medicine treatment group were caused by acupuncture or puncture. Conclusions This study analyzed clinical studies of Korean medicine treatment on nocturnal enuresis in children, identified the research trends and evaluated the effectiveness and safety of the Korean medicine treatment.

• Journal of Acupuncture Research
• /
• v.26 no.4
• /
• pp.11-18
• /
• 2009

Objectives : The objective of this review was to evaluate clinical trials of warming acupuncture for musculoskeletal pain diseases, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects and to identify the effectiveness of the warming acupuncture. Methods : Seven databases and the Journal ZHONGGUO ZHENJIU(中國鍼灸) published between 2004－2008 were searched. Korean and Chinese randomized trials were evaluated for methodologic quality using the modified Jadad scale. Outcome measurements were pain, function and global improvement. The best-evidence synthesis was performed to determine the strength of evidence by control group. Results : Six clinical trials representing 564 patients with musculoskeletal pain diseases were identified. For pain and function, there was moderate evidence that warming acupuncture is more effective than manual acupuncture. For patient global assesment, there was limited evidence that warming acupuncture is more effective than manual acupuncture. However, for function, there was inconclusive evidence that warming acupuncture is more effective than acupuncture with TDP or western medicine or acupoint-injection treatment. Conclusions : The evidence suggests that warming acupuncture is more effective for musculoskeletal pain diseases than manual acupuncture, acupuncture with TDP, western medicine and acupoint-injection treatment. But the evidence is moderate to inclusive due to the low methodologic quality of the trials. Further clinical trials with high methodologic quality is required to investigate the effectiveness of warming acupuncture.

• The Journal of Internal Korean Medicine
• /
• v.39 no.4
• /
• pp.520-549
• /
• 2018

Objectives: We performed a systematic review and meta-analysis to explore the recent clinical research trends regarding the effects of traditional herbal medicine (THM) on chemotherapy-induced leukopenia. Methods: Randomized controlled trials that verified effects of herbal medicine treating chemotherapy induced leukopenia were included in the study. A literature search was performed in the English, Chinese, and Korean databases for papers published from January 1, 2007, to September 1, 2017. The selected literature was assessed by Cochrane's Risk of Bias (RoB). Results: Forty-two of 232 randomized controlled trials met the inclusion criteria. The most commonly used herbal prescriptions called '升白湯 (shengbai decoction)' which means elevating the numbers of White blood cells (WBCs). And the mostly included herbs such as Astragali Radix, Angelicae Gigantis Radix, Atractylodis Rhizoma Alba, Codonopsis Pilosulae, Glycyrrhizae Radix, Ligustri Lucidi Fructus are commonly used to elevate qi, blood and yin. The count of WBC in peripheral blood, the level of leukopenia presented in WHO (World Health Organization), and clinical symptoms were used to evaluate the treatments. The effective rate was 68.6-98.18% and the effectiveness was significantly higher in the intervention group than in the control group in 38 articles (p<0.05). No serious adverse events were reported. Only five articles (5/42, 11.9%) were rated as having adequate methodological quality with a low level of bias. Conclusion: Some traditional herbal medicines may be effective as therapeutic treatments for chemotherapy-induced leukopenia, but the majority of reviewed studies were of poor quality. The present findings need to be confirmed by rigorously conducted high-quality trials, including pharmacokinetic studies, to confirm the absence of interactions between traditional herbal medicine agents and chemotherapy.