Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.2
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pp.202-209
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2018
This study analyzed the effects of the nutrient intake on oral health and chewing difficulty according to the age group. The subjects were 5,855 participants of the third Korea National Health and Nutrition Examination Survey(KNHANES VI), 2015, Korea Centers for Disease Control and prevention and aged 20 years and over. The data were analyzed using SPSS Ver 21.0, classified as the difficulty in chewing group (DC) and no difficulty in chewing group (NDC). As a result, the DC rates were 5 times higher in the 60+ year age group (39.5%) than in the 20-39 year age group (8.1%). The DC group were experience periodontal disease (33.4%), dental caries (30.1%), diabetes (41.8%), myocardial infarction (57.3%), arthritis (44.0%), asthma (48.0%), and depression (41.9%). In addition, 86% of the DC group were experiencing speech problems. The DC group had significantly lower intakes (1446.59g), than the NDC group (1666.62g), and the protein, carbohydrate, dietary fiber and other dietary intake were significantly lower. These findings suggest that the chewing difficulty is related to the nutrient intake, and psychological status in the elderly DC group. Therefore, the care of chewing difficulties is essential for the elderly to maintain a healthy lifestyle. Accordingly, oral care and myofunctional therapy are needed to maintain oral health.
Background: With effective early treatments, many breast cancer patients suffer from psychological distress due to adverse effects and lifelong physical disfigurement. Our study aimed to evaluate the psychopathological profile of breast cancer patients in comparison with healthy women and explored demographic correlates. Method: We consecutively enrolled breast cancer patients who came to the hospital for follow-up or rehabilitation care after primary treatment, and healthy female relatives or friends of inpatients in the Cancer Institute of Chinese Academy of Medical Sciences between August 30, 2010 and January 1, 2012. Psychopathological profile was assessed based on the Symptom Checklist-90-R (SCL-90-R) for patients and controls. We compared demographics such as age, ethnicity, education, marriage, and occupation, and incorporated these data plus cancer status for the association with the general SCL-90-R index and scores for 9 major symptom dimensions in multiple regression analysis. Results: We surveyed a total of 291 female breast cancer patients and 531 healthy women. The average age was $55.1{\pm}6.40$ years for breast cancer patients and $43.1{\pm}12.8$ for healthy controls (P<0.01). The mean survival was 5.20 years for cancer patients (range, 0.60-9.90 years). There were statistically significant differences in education, marriage, and occupation between the two groups (P<0.01). General index ($1.45{\pm}0.45$ versus $1.32{\pm}0.37$) and 8 dimension scores (excluding anxiety) on SCL-90-R were significantly higher in patients (P<0.05). Multiple regression analysis showed that the breast cancer status was positively correlated with general SCL-90-R index and 6 dimension scores (excluding the anxiety, phobic anxiety and paranoid ideation dimensions) (P<0.05). Regression coefficients ranged from 0.10 (depression) to 0.19 (somatization). Higher interpersonal sensitivity was noticed in single women compared to married women. Conclusions: Chinese patients with breast cancer demonstrate greater psychopathology compared to healthy controls. The breast cancer status is an independent contributing factor to the general psychopathological profile. Breast cancer patients should be given particular counseling and care to alleviate their psychological distress.
Seo, Ji-Hyun;Kim, Bukyung;Bae, Hwa-Ok;Im, Sun Ju;Kim, Kyung Han
Korean Medical Education Review
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v.16
no.2
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pp.67-76
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2014
Few studies have examined burnout among the faculty of medical schools in the Republic of Korea. The aim of this study was to determine the level of burnout and its associated factors among the faculty members of three medical schools in the Busan-Gyeongnam area, and to summarise the available literature on burnout. We conducted the survey using a validated questionnaire that incorporated the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as well as questions about demographic characteristics, working experience, health, lifestyle, most time spent and most difficult work, and suicidal ideation and job quitting ideation of the survey participants. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (De), and personal accomplishment (PA). Through the survey, the 186 professors, 49% among the total, provided data which were included in the present analysis. More than thirty per cent (37.1%) of the professors reported at least 1 symptom of burnout. For burnout dimensions, 11.8% of the respondents scored high for EE burnout, 25.3% for De, and 14.5% for PA, with 1.6% scoring high on all three dimensions of burnout. High burnout was found to be strongly associated with several of the variables under study, especially hours worked per week, self-rated health, career (range, 4 to 9 years), and age (range, 50 to 59 years). The EE score was highest for the professors who chose 'patient care' as the most difficult type of work. This study showed that just over one-third of professors have at least 1 symptom of burnout and working more hours per week, short length of work (years), and especially suicidal ideation seem to be associated with the burnout of medical school faculty members in the Busan-Gyeongnam area. In summary, a greater risk of burnout of physicians (including medical professors) seems to be associated with specialties at the front line of care, working more hours per week, work-life imbalance, low self-efficacy, depression, and conflicts with colleagues and patients.
By studying on the characteristics of cancer patients who receive radiotherapy and the attitudes of medical social workers, this thesis aims to suggest of requirements for medical social work intervention. The study was conducted using SPSS 10.0 for Windows to analyze data taken from a survey involving 90 cancer patients receiving radiotherapy in 4 general hospitals in Daejeon city. The data were collected form Oct. 1st to 15th, 2003, and its analyses used averages, correlation, and regression. The results were summarized as follows ; 1. The average family income in 67.8% of the cases was less than 2,000,000 won, which is a lower income bracket. In the disease characteristics, fatigue ware the highest (2.78) in the side effects of radiotherapy, which most patients were receiving alongside other forms of treatment. 2. It was shown that cancer patients receiving radiotherapy receive a high level of psychological and social support from doctors and other medical staffs, and that they also received a high average (4.38) of individual care and encouragement from family members. 3. In the psychosocial status, the need for financial assistance in the form of a national aid program or an expansion of medical insurance was great, especially in the need for house keeping service and night nurses. The need for psychosocial counselling rose following rises in treatment side effects and depression. Information for cancer patients was especially needed in the areas of treatment plans, treatment costs, and side effects of radiotherapy. The need for information rose in accordance with an elongation of hospital treatment and an escalation of care from family members.
Journal of the Korean Data and Information Science Society
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v.27
no.5
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pp.1349-1360
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2016
The purpose of this study was to identify the degree of quality of life (QoL) and its related factors in patients with Korean Chronic Obstructive Pulmonary Disease (COPD). With data collected by Korea National Health and Nutrition Survey in 2013, general and disease-related variables, pulmonary function test, and EuroQol-5Dimension (EQ-5D) were analyzed. The mean of EQ-5D index was 0.916 in patients with COPD and 0.941 in non-COPD. The EQ-5D index and its sub dimensions (mobility, self-care, usual activity, pain/discomfort, anxiety/depression) of COPD patients were significantly lower than that of non-COPD. However, difference in COPD patients' airway limitation was significant only for self-care of EQ-5D (${\chi}^2=9.50$, p=.013). The related factors of QoL in COPD patients were age, gender, level of education, quartile of household income, smoking status, and number of comorbid diseases. Based on the results, it is important to pay close attention to COPD patients' QoL as well as comprehensive interventions which possibly improve their QoL.
This study aims to identify determinants affecting on geographic variations in the prevalence of arthritis in Korean women using data mining. Data from Korean Community Health Survey 2012 with 249 small districts were analyzed. Socio-demographic, health behavior and status, and morbidity status measures were analyzed using conventional regression model and convergence analysis method such as decision tree for convergence analysis. Rate of workers in agriculture, forestry, and fishing, salaried workers, persons higher than high school graduates, non-treatment of needing care, non-treatment of care because of economic reason, obesity, heavy drunkers, complaining persons of chewing difficulty, persons with experiencing depression, persons with perceiving stress, and persons with diagnosing hypertension and angina pectoris were variation determinants of prevalence of arthritis in 249 small districts and these districts were classified 10 area groups by decision tree model. Our finding suggest that the approach based characteristics by small area groups rather than national wide or individual level would be effective to reduce in variations of prevalence of arthritis.
Crosstalk between G-protein signaling and glutamatergic transmission within the brain reward circuits is critical for long-term emotional effects (depression and anxiety), cravings, and negative withdrawal symptoms associated with opioid addiction. A previous study showed that Regulator of G-protein signaling 4 (RGS4) may be implicated in opiate action in the nucleus accumbens (NAc). However, the mechanism of the NAc-specific RGS4 actions that induce the behavioral responses to opiates remains largely unknown. The present study used a short hairpin RNA (shRNA)-mediated knock-down of RGS4 in the NAc of the mouse brain to investigate the relationship between the activation of ionotropic glutamate receptors and RGS4 in the NAc during morphine reward. Additionally, the shRNA-mediated RGS4 knock-down was implemented in NAc/striatal primary-cultured neurons to investigate the role that striatal neurons have in the morphine-induced activation of ionotropic glutamate receptors. The results of this study show that the NAc-specific knock-down of RGS4 significantly increased the behaviors associated with morphine and did so by phosphorylation of the GluR1 (Ser831) and NR2A (Tyr1325) glutamate receptors in the NAc. Furthermore, the knock-down of RGS4 enhanced the phosphorylation of the GluR1 and NR2A glutamate receptors in the primary NAc/striatal neurons during spontaneous morphine withdrawal. These findings show a novel molecular mechanism of RGS4 in glutamatergic transmission that underlies the negative symptoms associated with morphine administration.
Park, Shin-Ae;Kang, Kyung-Sook;Jeong, Mi-Young;Cha, Nam-Hyun;Kim, Soon-Young
Research in Community and Public Health Nursing
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v.12
no.3
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pp.639-646
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2001
The purpose of this study is to analyze the trend of nursing research related to family support and to provide an effective direction for future research by conducting a review of the Korean nursing literature from 1980 to 2000. A total of 73 studies were analyzed with the following results. 1) The number of studies related to family support has been rapidly increasing since 1984, and 77% of those were conducted in the 1990s. 48 studies, 65% of those analyzed. were degree-based research including 4 doctoral theses (4%) and 45 master's theses (62%). 2) Based on the objective frame of study types developed by Lee et al. (991), the types of studies were analyzed: 56 studies, 76.6% of those reviewed, belonged to factor-relating: 9 studies (12.4%) belonged to factor-isolating: 7 studies (9.6%) belonged to situation-producing: and only 1 study (1.4%) belonged to situation-relating research, respectively. 3) In terms of research design, most studies of analyzed (90.4%) were conducted by non-experimental design, and 7 studies (9.6%) were conducted by experimental design. But, qualitative research related to family support was not found. 4) In terms of research subjects, target populations of experimental studies were patients with arthritis, mental disorder, tuberculosis, coronary artery disease and hypertension. In correlational studies, 51 studies, 69.9% of those analyzed, were conducted to patients with renal failure, cancer and hemiplegia, and 5 studies (6.8%) were conducted to aged people and adolescents. 5) Study concepts used in correlational studies were quality of life, anxiety and depression, self-esteem, hope, role behavior, compliance and self-care activities. The quality of life was most often used among studies with 12.5% of those analyzed. 6) Nursing interventions, including diet therapy, family involving education and supportive care, used in experimental studies mostly showed positive effects on client involvement and home health improvement. However, the nursing interventions of mental health rehabilitation and resistance exercise showed neutral and negative results. The findings of this study provide evidence that more empirical research including experimental or qualitative studies should be conducted actively to improve nursing practice related to family support. Also, to promote more diverse nursing interventions, a family assessment tool especially for Korean families needs to be developed.
This study analysed the income-related health inequality of the aged in Korea applied to EQ-5D. Two decompositions were used in analysis. One was the decomposition of income-related health inequality into six different dimensions of EQ-5D, and the other was to decompose it by sub-group such as sex, region, existence of spouse. The results are summarized as follows. First, the health concentration index(CI) of the aged was .0254, which meant that there were pro-rich inequality in elderly people's health levels. The same patterns were also seen in the analysis of different dimensions of EQ-5D such as mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Second, mobility accounted for 35.8% of total EQ-5D score, most contributing to CI of the dimensions of EQ-5D. The CIs by the dimensions ranged from .0091 for mobility to .0013 for self-care. Third, The decompositions by sub-groups showed that the contributions of sex, region, and existence of spouse to health inequality was similar to each other, all of three sub-groups accounted for 10 % of inequality respectively. Fourth, the inequality within group was higher in female group, rural area, and the aged without spouse. The average health level of these groups was lower than that of the other ones, too. These facts indicated that old women, the aged without spouse, and the elderly in rural area were the most vulnerable groups in health problems. Therefore, it is necessary to pay more attention to health problems of these groups in the policy making of health security and social welfare services.
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