• Perspectives in Nursing Science
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• 제2권1호
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• pp.76-91
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• 2005

Stroke patients often develop post stroke sequelae when they survive. Post stroke fatigue and emotional disturbances including depression are common along with motor dysfunction. However, medical personnel have paid relatively little attention to emotional changes and the presence of fatigue following strokes. Post-stroke fatigue was common, occurring in 57% of the patients in our series. The post-stroke fatigue appears to be related to the pre-stroke fatigue, physical disability and post stroke depression (PSD) although the relation to the lesion location remains elusive. The prevalence of post-stroke emotional disturbance has been reported to range from 12% to 64%. The wide variation in the frequency of post stroke depression may be related to methodological heterogeneity in items such as the criteria for depression, the timing of assessment, and the study population. Emotional incontinence, which is characterized by inappropriate or excessive laughing or crying is also common. The incidence of and factor related to this post-stroke emotional incontinence (PSEI) also remains unclear. We reported that out-patients with single, unilateral stroke, 18% had PSD and 34% had PSEI. Although both PSD and PSEI were related to motor dysfunction and location (anterior vs. posterior cortex) of the lesion, the latter was a stronger determinant for PSD. PSEI was more closely associated with subcortical strokes than was PSD. Another manifestation of post stroke patients is the occurrence of post stroke anger proneness (PSAP). They may become easily irritated, impulsive, less generous, and prone to be angry or aggressive at others. We also have reported the PSAP which seems to be closely associated with the presence of PSEI. The lesion distribution appears to be also similar. Both PSEI and PSAP respond well to serotonin reuptake inhibitors suggesting that these symptomsmay be possibly related to the alteration of serotonin after brain injury. Likewise, PSAP also produces a great deal of frustration and embarrassment among patients and caregivers. In summary, emotional disturbances such as depression, emotional incontinence, anger-proneness and fatigue are fairly common but under-recognized sequelae of stroke. These emotional disturbances decrease the quality of life of the patients and caregivers, and may adversely affect the overall prognosis. Therefore, these problems must be appropriately recognized and alleviated. Finding strategies to relieve the symptoms is imperative by understanding the causative factors in individual patient.

• 근관절건강학회지
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• 제26권2호
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• pp.90-101
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• 2019

Purpose: This study was aimed to describe older adults' experiences of living with urinary incontinence and using diapers for its management in long-term care facilities. Methods: Qualitative data were collected through in-depth interviews with 22 participants in long-term care facilities. Content analysis was used to analyze the data. Results: Three themes and six categories were emerged. Participants navigated through those three categories as stages, including the initial stage of confronting the unacceptable reality, transitional stage of physical and emotional suffering, and adaptive stage of accepting the diaper usage as a part of life and hoping improvement. Six categories were feeling terrible with unavoidable use of diapers, being frustrated by nursing staff shortage and unsatisfactory care for urinary incontinence, physical discomfort from of wearing diapers and remaining unchanged, emotional difficulties due to using diapers, accepting and adapting to diaper usage as a part of life, hope for gender-specific quality care for urinary incontinence. Conclusion: The findings suggest that using diapers should not be mandatory to manage older adults' urinary incontinence in long-term care facilities. It is also critical to establish policies to address issues of nursing shortage and financial support for qualitative care to manage urinary incontinence in long-term care settings.

• 지역사회간호학회지
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• 제25권3호
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• pp.198-206
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• 2014

Purpose: The purposes of this study were to identify the prevalence and influencing factors of fecal incontinence, and to analyze the association between fecal incontinence and depression. Methods: The subjects of this study were 233 women living in rural areas, and data were collected using questionnaires from February 24 to May 30, 2012. Fecal incontinence was measured with the Continence Grading Score, and depression with the Geriatric Depression Scale. Collected data were analyzed using SPSS through $x^2$-test, Fisher's exact test, t-test and ANOVA. Results: Of the subjects, 16.7% had fecal incontinence. The prevalence of fecal incontinence was higher in older women ($x^2=23.55$, p<.001), those with vaginal delivery ($x^2=4.81$, p=.049), those with parity of 4 or more ($x^2=13.47$, p=.003), and those with urinary incontinence ($x^2=26.36$, p<.001). The level of depression was significantly higher in older women (F=19.27, p<.001), those with low academic qualification (F=18.17, p<.001), those with urinary incontinence (F=4.15, p=.043), and those with fecal incontinence (F=14.90, p<.001). Conclusion: These results suggest that there should be supports by public health care for fecal incontinence prevention and care programs in order to promote the physical and emotional health of rural women.

• Advances in pediatric surgery
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• 제6권1호
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• pp.27-31
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• 2000

Fecal incontinence is not rare in children who have been operated upon for anorectal malformation, Hirschsprung's disease, and meningomyelocele. Incontinence can negatively impact on the emotional and social development of these children. Antegrade continence enema (ACE) was utilized in 9 patients with meningomyelocele from January 1998 to June 1999. Cleanliness and post-operative complications were evaluated. Three operative techniques were employed; reversed appendicocecostomy, in situ appendicostomy and neoappendicostomy with cecal flap. All of the patients achieved complete fecal cleanliness. Four patients had post-operative complications; two with stoma leakage, one with abdominal pain on irrigation and one with stoma stenosis. The leakage was minimal and the pain on irrigation improved spontaneously. The stoma stenosis required revision 6th month postoperatively. The ACE has been shown to be safe and highly effective.

• 모자간호학회지
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• 제4권1호
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• pp.12-23
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• 1994

This study was done to determine the situations of stress incontinence(SI) and the differences in general characteristics, obstetrical history and SI related variables between women with stress incontinence and normal women. The design for study was a descriptive study. The number of subjects consisted of 156 women who were selected by systematic random sampling in Kwangju city. Data collection was done with the modified Hendrickson's Stress Incontinence Scale(1981) which was analyzed using frequency and percentiles. The results were as follows : 1. The stress incontinence (SI) rate of the sample was 64.1% and the majority of the women(40.9%) had experienced SI for a period of five years(the mean period was 2.7 years) without any treatment or care(83.0%). The amount of SI was from one drop(40.0%) to one teaspoon(16.7%) daily. 2. Items on the SI scale had the scores ranging from 4 to 44 with a mean score of 13.7 which showed mild SI. 3. The priority of provocative factors for SI were abdominal tightening(83%), coughing(58%), laughing(52%), sneezing(40%), steeping(18%), sudden standing(17%), nose blowing(13%), heavy exercise(11%), rapid walking up-stairs(10%) and excitment (9%) in that order. 4. There were no significant differences in age, education, spouse, job and income between the women with SI and the normal women. 5. There were no significant differences in the age at the last delivery, age of last baby. number of vaginal, or cesarean deliveries, or abdominal operations between the women with SI and the normal women. It can be concluded that SI in women has a high incidence nth various provocative factors but it is relatively mild SI on a daily basis and generally there has been no treatment. It is suggested that a descriptive study of emotional problems and precipitating variables in SI women will increase the knowledge of SI.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.575-579
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• 2005

Urinary incontinence is the most common urinary symptom in children and causes considerable anxiety in children and parents. In most cases, there is no underlying organic pathology and the longterm prognosis is excellent. Despite these reassuring facts, children with wetting problems can be a challenge for primary pediatrician. This is probably because the problem is poorly understood, there is no readily identifiable medical pathology, and because treatment is usually time consuming and arduous. There is a great demand for treatment because wetting is an unpleasant symptom that can cause a stress and anxiety in the family. There may also be other coexisting problems such as urinary tract infection, constipation, soiling, and behavioral or emotional difficulties. Despite the frequency and vexing nature of voiding dysfunction, physicians may not always obtain a careful history to identify and to treat children properly with this condition. This article addresses the comprehensive diagnostic and therapeutic approach to such children.

• Journal of Acupuncture Research
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• 제23권1호
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• pp.63-70
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• 2006

Objectives : This study was designed to evaluated the effect of electroacupuncture on Quality of life of patients with urinary incontinence Methods : Subjects were voluntarily recruited by newspapers and internet. Electroacupuncture was performed three times a week for 3 weeks. Acupuncture point for EA group was B32, Electrical stimulation frequency was 2Hz, duration 20 minutes, and intensity was up to pain threshold according to patients. The patients's symptoms were assessed before, after 3 weeks of treatment by QOL item of International Prostate Symptom Score(IPSS), Medical Outcomes Study(MOS) 36-Item Short-Form Health Survey(SF-36). Results : QOL score of IPSS were significantly improved after 3 weeks(p<0.05) compared to the pre-treatment. There were significant changes in Social functioning(SF), role-physical(RP), role emotional(RE), mental health(MH), bodily pain(BP) score of SF-36 after 3 weeks(p<0.05), but there were no significant changes in physical functioning(PF), vitality(VT), general health(GH) score of SF-36. Conclusion : This study suggests that electroacupuncture treatments can be applicable to improve symptoms in patients with urinary incontinence.

• 대한간호학회지
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• 제27권4호
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• pp.943-952
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• 1997

This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone & Salisbury(1991) was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of dally life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack & Peck(1960), elderly mental depression, using the tool developed by Sheikh & Yesavage(1986), and the ADL(activities of dally living), through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems nth their cognitive, mental and physical functions.

• 대한통합의학회지
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• 제6권2호
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• pp.69-76
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• 2018

Purpose : This study investigated the effects of low-intensity muscle training on neurotransmitters associated with depression and emotion regulation disorders in survivors with stroke who were diagnosed with depression or emotion regulation disorder. Methods : Survivors of chronic stroke diagnosed with depression or emotion regulation disorder (n = ) were included in the study. Concentrations of serotonin, norepinephrine, and epinephrine were measured before and after. Low-intensity muscle training was performed once a day for 50 minutes, 5 times a week for 10 weeks. Result : Levels of serotonin, norepinephrine, and epinephrine improved significantly after intervention (p < .05). Conclusion : These results confirm that low-intensity muscle training has a positive effect on neurotransmitter concentrations in survivors with stroke diagnosed with depression and emotion regulation disorders. Future studies should analyze the changes in neurotransmitters in more detail using various exercise methods and intensities to investigate their effects on depression and emotion regulation disorders.

• 여성건강간호학회지
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• 제8권2호
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• pp.301-313
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• 2002

The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.