• Title/Summary/Keyword: Clinical adjustment

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Construction of the structural equation model on college adaptation in nursing students (간호대학생의 대학생활적응 모형)

  • Kim, Youngsun;Seo, Jiyeong
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.6
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    • pp.1439-1452
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    • 2015
  • Purpose: The purpose of this study was to construct a SEM that would further explain the college adaptation for nursing students. Methods: Model construction was based on the variables; mother attachment, self concept, stress, stress of clinical practice, psychological well-being, coping, and college adaptation. The analysis of data was done with both SPSS 20.0 for descriptive statistics and AMOS 20.0 for SEM. Results: The psychological well-being and coping was found to have a significantly direct effect in predicting college adaptation. In addition, mother attachment, self concept, and stress were found to have a significantly direct effect in predicting college adaptation. The final modified model yielded ${\chi}^2=231.1$ (p <.001), ${\chi}^2/df=2.36$, GFI=.91, AGFI=.86, NFI=.91, PNFI=.73 RMSEA=.07, and CFI=.95. Conclusion: To improve adjustment to college life, it is recommended to have a direct method of developing psychological well-being and coping improvement program to improve mother attachment.

Osteoporosis in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome

  • Oh, Jee Youn;Lee, Young Seok;Min, Kyung Hoon;Lee, Sung Yong;Shim, Jae Jeong;Kang, Kyung Ho;Hur, Gyu Young
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.73-79
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    • 2018
  • Background: Osteoporosis is a common disease that occurs comorbidly in patients with chronic inflammatory airway diseases, including asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap syndrome (ACOS). However, the prevalence of osteoporosis in patients with ACOS has not widely been evaluated. Therefore, we investigated the prevalence of osteoporosis and its relationship with the clinical parameters of patients with asthma, COPD, and ACOS. Methods: This was a retrospective, cross-sectional study. Bone mineral density (BMD), lung function tests, and disease status evaluations were conducted. Results: A total of 321 patients were enrolled: 138 with asthma, 46 with ACOS, and 137 with COPD. One hundred and ninety-three patients (60.1%) were diagnosed with osteoporosis (53.6% of asthma, 65.2% of ACOS, and 65.0% of COPD). Patients with ACOS showed a significantly lower BMD and T-score than did those with asthma. In addition to age, sex, and body mass index (BMI), which were previously reported to be associated with BMD, BMD also had a negative correlation with the diagnosis of ACOS, as compared to a diagnosis of asthma, after adjusting for age, sex, BMI, smoking, and inhaled corticosteroid use (p=0.001). Among those patients with COPD and ACOS, BMD was negatively associated with the COPD Assessment Test (CAT) after adjustment (p<0.001). Inhaled corticosteroid was not associated with the prevalence of osteoporosis and BMD. Conclusion: Patients with ACOS, particularly aged and lean women, should be more carefully monitored for osteoporosis as compared to patients with asthma.

Heart-Model-Based Automated Method for Left Ventricular Measurements in Cardiac MR: Comparison with Manual and Semi-automated Methods (자동화 방식 모델 기반 좌심방 파라미터 측정법: 수동 및 반자동 방식과의 비교)

  • Chae, Seung Hoon;Lee, Whal;Park, Eun-Ah;Chung, Jin Wook
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.200-206
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    • 2013
  • Purpose : To assess the effect of applying an automated heart model based measurements of left ventricle (LV) and compare with manual and semi-automated measurements at Cardiovascular MR Imaging. Materials and Methods: Sixty-two patients who underwent cardiac 1.5T MR imaging were included. Steady state free precession cine images of 20 phases per cardiac cycle were obtained in short axis views and both 2-chamber and 4-chamber views. Epicardial and endocardial contours were drawn in manual, automated, and semi-automated ways. Based on these acquired contour sets, the end-diastolic (ED) and end-systolic (ES) volumes, ejection fraction (EF), systolic volume (SV) and LV mass were calculated and compared. Results: In EDV and ESV, the differences among three measurement methods were not statistically significant (P = .399 and .145, respectively). However, in EF, SV, and LV mass, the differences were statistically significant (P=.001, <001, <001, respectively) and the measured value from automated method tend to be consistently higher than the values from other two methods. Conclusion: An automatic heart model-based method grossly overestimate EF, SV and LV mass compared with manual or semi-automated methods. Even though the method saves a considerable amount of efforts, further manual adjustment should be considered in critical clinical cases.

Relationship between Percutaneous Transluminal Coronary Anigioplasty Volume and Associated Immediate Outcome (경피적 관동맥 확장술의 시술량과 조기 시술결과의 관련성)

  • Kim, Yong-Ik;Kim, Chang-Yup;Lee, Young-Sung;Kim, Sun-Mean;Lee, Jin-Seok;Oh, Byung-Hee;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.9-20
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    • 2001
  • Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

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A Study on the Angyo Method of Doin Angyo - Whidam's Su-Gi Therapy Based on the Principles of Medical Gigong (도인안교(導引按蹻) 중 안교법(按蹻法)에 대해 - 의료기공 원리에 근거한 휘담식 수기요법)

  • Ahn, Hun Mo;Lee, Jae Heung;Na, Sam Sik
    • Journal of Korean Medical Ki-Gong Academy
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    • v.19 no.1
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    • pp.1-24
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    • 2019
  • Objective : The purpose of this study is to understand a medical Gigong's view of the human body through the analysis of medical Gigong techniques, and to understand the concept and treatment principle of Whidam's Su-Gi therapy as the Angyo(按蹻) Method of Doin Angyo(導引 按蹻) Methods : Among Medical Gigong, Sojucheon practice, Moosim-Gigong Riding stance, Moosim-Gigong Doinbeop, Hwalinsimbang Doinbeop and Donguibogam Jang-Bu Doinbeop were selected to analyze the practice method. The medical Gigong's views of the human body are organized into overviews and pathological perspective. The main concepts and clinical techniques of Whidam's Su-Gi therapy were summarized. Discussion : Understanding the principles of medical Gigong is necessary in order to understand the Angyo method of Doin Angyo. The principle of medical Gigong is to circulate around Three-Danjeon(丹田) on the human belly and Three-Gwan(關) on the human back by practicing medical Gigong, and to strengthen the life force by activating the viscera function by communicating between the limbs and the body. If there are Jeokchwi(積聚) and deviation, Whidam's Su-Gi therapy eliminates the Jeokchwi and adjusts the deviation. Conclusions : 1. The Angyo method of Doin Angyo originates from the practice of training to establish Danjeon for the right body and the right flow of air. 2. The principles of medical Gigong obtained through the analysis of Sojucheon(小周天) practice, Moosim-Gigong Riding stance, Moosim-Gigong Doinbeop, Hwalinsimbang Doinbeop and Donguibogam Jang-Bu Doinbeop are the medical Gigong's view of the human body and pathological perspective. 3. Whidam's Su-Gi therapy, which focuses on the elimination of Jeokchwi and the adjustment of deviation based on the medical Gigong's view of the human body, is a manual therapy that inherits the principle of the Angyo Method of Doin Angyo.

The Refinement Project of Health Insurance Relative Value Scales: Results and Limits (건강보험 상대가치 개정 연구의 성과와 한계)

  • Kang, Gil-Won;Lee, Choong-Sup
    • Health Policy and Management
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    • v.17 no.3
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    • pp.1-25
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    • 2007
  • Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

  • Song, SuJin;Kim, Eun-Kyung;Hong, Soyoung;Shin, Sangah;Song, YoonJu;Baik, Hyun Wook;Joung, Hyojee;Paik, Hee Young
    • Nutrition Research and Practice
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    • v.9 no.5
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    • pp.554-562
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    • 2015
  • BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged ${\geq}30y$ were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Prosthetic rehabilitation of an oligodontia patient with atrophic maxilla (위축된 상악골을 가진 부분무치증 환자의 보철수복)

  • Chi, Seung-Seok;Kim, Ye-Jin;Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.238-247
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    • 2021
  • Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

Mediating and Moderating Effects of Self-esteem, Social Participation and Discrimination Experience in the Relationship between Acceptance of Disability and Social Competence in Adults with Physical Disabilities (지체장애인의 장애수용과 사회적 유능감 간의 관계에서 자존감, 사회참여, 차별경험의 매개 및 조절효과)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.377-386
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    • 2019
  • The purpose of this study is to identify effective strategies for promoting psycho-social adjustment by examining the mediating effects of self-esteem (SE) and moderating effects of social participation (SP) and discrimination experience (DE) in predicting social competence (SC) with acceptance of disability (AD). The subjects of the study were 1943 adults with a physical disability (1338 males and 605 females) and 233 adults with brain lesions (160 males and 73 females) aged between 19 and 65 years. Data were analyzed using SPSS and Process macro software, and conditional process analysis (model 18) in which the degree and onset of disability were controlled was performed. The results are as follows. First, SE was found to partially mediate the relationship between AD and SC. Second, the relationship between SE and SC was found to be moderated by SP but not by DE, and the relationship between SP and SC was found to be moderated by DE. In addition, the mediating effects of SE, which was moderated by SP, were found to not be moderated by DE. The clinical implication and suggestion for future research is discussed.