• 대한간호학회지
• /
• 제32권5호
• /
• pp.665-672
• /
• 2002

It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. Method: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories : bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. Result: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. Conclusion: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

• Journal of Welding and Joining
• /
• 제25권4호
• /
• pp.79-85
• /
• 2007

The industrial disaster caused by a work-related disease like a Musculoskeletal Disorders(MSDs) becomes a big social problem and increases rapidly. This leads to the degradation of the labor desire and the productivity. Welding work belongs to the work with a high intensity. This paper aims to analyze the welding work in the various positions from a view-point of the burden of the human musculoskeletal system and to propose the desired position with lower burden. For this purpose the real welding work was observed in the shipyard and analyzed using the RULA method, a powerful ergonomics tool. The 3-dimensional simulation model fur this work was also developed. In this model, ergonomics human model and welding work environment were built. This model was verified through the comparison to the real work. This paper showed that the improvement of welding position by changing the location of a stool and using some auxiliary tool can reduce the work intensity remarkably and lead to the decrease of MSDs.

• Clinical and Experimental Pediatrics
• /
• 제62권6호
• /
• pp.199-205
• /
• 2019

Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권3호
• /
• pp.1905-1909
• /
• 2013

Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of health-related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권sup3호
• /
• pp.197-200
• /
• 2016

On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.

• Journal of Preventive Medicine and Public Health
• /
• 제42권4호
• /
• pp.243-250
• /
• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• 보건행정학회지
• /
• 제33권4호
• /
• pp.389-399
• /
• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Tuberculosis and Respiratory Diseases
• /
• 제80권1호
• /
• pp.11-20
• /
• 2017

Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권12호
• /
• pp.6169-6173
• /
• 2012

Infection by human papillomavirus (HPV) is one of common sexually transmitted diseases leading to cervical cancer. Evaluation of parental knowledge and attitudes toward HPV were aims of present study to provide an appropriate method to decrease burden of this infection on society. During this study, 358 parents were assessed for knowledge about HPV and its related disorders. Some 76% of parents had no information about HPV infection and among the informed parents 36% had obtained their information via internet and others from studying medical resources. The average score of mothers information about HPV infection was higher than that of fathers, and also educational level and age had significant impact on knowledge of parents about HPV. Parent knowledge about the hazards of HPV was higher than their knowledge about modes of transmission. Lack of awareness about HPV infection was high in this study, underlining the urgency of education among all adult people in our society.

• 기본간호학회지
• /
• 제10권3호
• /
• pp.371-382
• /
• 2003

Purpose: The purpose of this study was to analyze research trends and to suggest future directions for research on families of patients with chronic disease. Method: The method used was a review of 83 dissertations and articles related to these families published in Korea between 1980 and 2002. Analysis included design of the study, sources of data, interventions for experimental research and main concepts for non-experimental research. Result: It was found that 80.7% of the studies were non-experimental research and 85.1% of these were descriptive surveys. In 79.5% of research studies, data were collected at a hospital. Nursing interventions in the experimental studies included stress management, education, strengthening functional communication among family members and nursing management. The major concepts were family burden, family stress, and coping, and family experience. Conclusion: It is necessary that research on the family-as-a-client be more focused and that the results of family related research be applied to the family as a unit. Development of research instruments to measure the phenomena of Korean families of patients with chronic disease is also needed.