• Title/Summary/Keyword: Depression Care

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Clinical Experience of Continuous Epidural Analgesia Using Baxter $Infusor^{(R)}$ (Baxter $Infusor^{(R)}$를 이용한 경막외 진통제 지속 주입)

  • Bae, Sang-Chull;Lee, Jang-Won;Kim, Ill-Ho;Song, Hoo-Bin;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.127-132
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    • 1991
  • Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

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The Relationship between Psychiatric Consequences and Injury Severity Following Traffic Accidents (교통사고후 외상심각도와 정신과적 증상의 관계)

  • Lee, Moon-In;Park, Sang-Hag;Kim, Sang-Hoon;Kim, Jae-Min;Kim, Hack-Ryul
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.66-75
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    • 2004
  • Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

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Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors (암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰)

  • Song, Chi Eun
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.586-600
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    • 2018
  • The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

Factors affecting on Health-Related Quality Of Life Among Cancer Survivors: Focusing on Gender Difference (암생존자의 건강관련 삶의 질에 대한 영향 요인 -성차를 중심으로)

  • Lee, In-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.497-507
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    • 2018
  • Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

Prevalence and Associated Risk Factors of Psychological Distress in Patients with Gastric Cancer (위암 환자의 디스트레스 유병률과 관련 위험 인자)

  • Jun, Chansoo;Min, Jung-Ah;Ma, Ji-Young;Song, Kyo Young;Lyoo, In Kyoon;Lee, Chang-Uk;Lee, Chul;Kim, Tae-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.82-90
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    • 2012
  • Objectives : Though gastric cancer is one of the most common cancer in Korea, there have been few studies to explore psychological distress in gastric cancer. The purpose of this study was to investigate the prevalence and associated risk factors of psychological distress among patients with gastric cancer. Methods : With consecutive sampling, a total of 274 patients with gastric cancer who admitted to a cancer center in a general hospital were recruited and assessed on psychological distress using the Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer-related clinical variables were also evaluated. Results : One hundred fifty-three(55.8%) patients with gastric cancer showed psychological distress. Logistic regression models revealed that having alcohol drinking experience[odds ratio(OR)=2.10, p=0,034] and low performance status(OR=2.40 p=0.002) were significantly associated with psychological distress in patients with gastric cancer. Conclusions : These findings indicate that approximately half of patients with gastric cancer suffered from psychological distress and having alcohol drinking experience and low performance status would be associated risk factors, suggesting the need for distress screening and psychosocial supportive care in patients with gastric cancer.

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Predictors of Persistence and Adherence with Secondary Preventive Medication in Stroke Patients (지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인)

  • Kim, Young Taek;Park, Ki Soo;Bae, Sang-Geun
    • Journal of agricultural medicine and community health
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    • v.40 no.1
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    • pp.9-20
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    • 2015
  • Objectives: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. Methods: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. Results: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). Conclusions: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.

Health Complaints of Elderly Persons Using a Modified C.M.I. (C.M.I.간이법에 의한 노인들의 건강수소율)

  • 박오장
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.44-57
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    • 1983
  • The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.

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Related Factors with Medication Task Ability in Rural Elderly (일부 농촌 노인에서의 약물복용 수행능력과 관련된 요인)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.35-47
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    • 1999
  • Medication non-compliance among the elderly results in medical problems and substantial cost to the health care system. This study investigate predicted variable related to the medication task ability among elderly. This study was done in the selected 4 villages in Kimchun County of Kyungbuk Province from July to August, 1996. The subject was the resident that 202 adults above 60 years of age. The questionnaire of interview included medication task ability, socio-demographic data, COOP/WONCA chart, family ABGAR score. BDI(Beck depression inventory), ADL(activities of daily living), IADL(instrumental activities of daily living), and MMSE-K(minimental state examination-Korean version). The results were as followed : 1. Approximately 49% of study population was taking drug medication currently. We found that 93% of study population was successful at the medication task all alone, 6% was failure at the medication task all alone, so need help partly or completely. 2. Significant variables between group of medication task ability were age, educational attainment, IADL, and MMSE-K in univariate analysis. And significant correlated variables with medication task ability were ADL, IADL, MMSE-K, and BDI in correlation analysis. 3. Major predictors to medication task ability on multiple logistic regression were IADL and sex finally. Findings suggest that IADL is related to medication task ability than other test battery of health status, so IADL could be used to necessary for medication management and add information to conventional methods of assessing mental status.

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Multicultural Childcare in Japan: Current Circumstances and Future Perspectives (다문화 사회에서의 일본의 「다문화보육」)

  • Kang, Ran Hye
    • Korean Journal of Childcare and Education
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    • v.5 no.2
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    • pp.73-90
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    • 2009
  • The number of multi-cultural members, such as immigrant labors, international marriage women are gradually increasing in Japan society. Now it might be said that Japan has become a multi-cultural society. Recently in Japanese kindergartens and nursery schools the numbers of foreign and bi-cultural children are increasing. The aim of this paper is to review the researches on the cultural diversity in the Japan, especially in childcare. Methodology proceeds from a review of related literature to internet-based data and to the statistics issued by the government. Through reviewing them, the problems of teachers' assumptions and the importance of discussions about teachers' competencies to educate minority children and to communicate with their parents were suggested. As a switch over to multi-cultural society is occurring in Japan, the attitude of assimilationism is weakening, and the local community is now beginning to tolerate the multi-cultural childcare. Consequently, It was over to age that is distinguish identity from only nationality.

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The health lifestyle of adults related to smoking, drinking and exercise (흡연, 음주, 운동과 건강생활양식)

  • So Hee Young;Lee Mi Ra;Cheong Mee Sook
    • Journal of Korean Public Health Nursing
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    • v.12 no.2
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    • pp.221-235
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    • 1998
  • This study is a descriptive survey to explore the health lifestyle of adults. The study subjects are teachers of elementary. middle and high school. and staffs of research institutes located in Chungchung Province and Daejon city. The data was collected from Jan. to march 1997 through self reporte for structured questionnaire. Fantastic check list of Wilson and Ciliska for Health Lifestyle Assessment and DSM-III-R for somatic symptom were used as tools. Data was analysed by frequency, $X^2_test$, t-test and Anova using SAS program. The results are as follows: 1. There were statistically significant differences In drinking(t=7.75, P=.000), exercise(t=-2.99, P=.003)and interpersonal relationship(t=2.22, P=.027) among 10 health lifestyle between smoking group and non-smoking group, in drinking(t=17.98, P=.000), exercise(-4.71. P=.000), and job satisfaction(t=2.22, P=.027) between drinking group and non-drinking group, and in eating habit(t=-2.00, P=.045), drinking (t=4.47, P=000), exercise (t= -16.49, P=000), keeping traffic law(t= -2.68, P=.007), personality (t= -2.05, P=.040) and anxiety/depression(t=-3.47, P=.000) between exercise group and non-exercise group. 2. There was statistically significant difference in cardiovascular symptom(F=4.22, P=.0l) among somatic symptoms of subjects according to exercise level. 3. There was statistically significance difference in lifestyle according to smoking level(F=, 3.33, P=.011), drinking level(F=9.17, P=.0001) and exercise level(F=11.93, P=.000l), and in somatic symptom according to sex(t=-3.93, P=.0001), weight(F=3.83, P=.022), exercise level (F=3.29, P=.03) among general characteristics. 4. There was statistically significant difference between sex in general (t= -3.64, P=.0001), gastrointestinal(t=-2.21, P=.02), musculoskeletal(t=-3.92, P=.001), and total symptom (t= -3.92, P=.0001). 5. There was statistically very highly signigicant difference In weight according to smoking($x^2=25.18,\; P=.001)$ and exercise$(x^2=16.46,\; P=001)$. 6. There was statistically significant difference in frequency between smoking group, drinking group and exercise group$(x^2=24.52,\;P=.001)$. Among a number of habit, smoking, drinking and exercise are important factors of human health to prevent related disease morbidity and death. It is essential for industrial health nurse to committ in this subject considering the influence of those factors and lifestyle on health. There is also a relationship of weight with smoking and exercise, the frequency of overweight/obesiy in smoking/ no-exercise group were high. It is quite necessary for the people having cardiovascular symptom to exercise to lower morbidity and mortality. The industrial health nurse has to keep In mind on this point and consider of time and facilities of fitness of employee. It needs to explore the cause by further research on somatic symptom of women. This research shows that concerning the relationship between smoking, drinking, and exercise, health care provider must take not only management of disease, but health behaviors and lifestyle into consideration.

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