• Journal of Acupuncture Research
• /
• 제21권4호
• /
• pp.19-29
• /
• 2004

Objective : The purpose of this study is to present the epidemiological data on patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital Kyung Hee University and to investigate the difference between preceding diseases of stroke. Methods : We reviewed medical records of 700 patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital, Kyung Hee University. Results: The incidence of cerebral infarction was 6.7 times that of cerebral hemorrhage. The incidence in males was 1.28 times of that in females. The incidence of stroke increased with aging and more cerebral hemorrhage occured in lower age group than cerebral infarction. There was higher morbidity in October, during the changing of the seasons, than any other months. Hypertension was the most common preceding disease followed by diabetis mellitus, heart disease, hyperlipidemia, and according to Odds's ratio for Male/Female, the probability of having preceding diseases was higher in females than males. In cerebral infarction, MCA territory was the most frequent lesion sites. Of the cerebral hemorrhage, basal ganglia (60%) was the most commonly involved site which was followed by thalamus(33.3%), cortex (3.3%) and subcortex (2.2%). The most common symptom accompanied by stroke was motor dysfunction which was followed by verbal disturbance, urination disorder and dysphagia. Conclusion : This study showed the trends of stroke in Oriental medical center. We expects that Multicenter cooperative and prospective study including Oriental Medicine will be inspired by this study for establishing more accurate chacteristics of stroke in Korea in the future.

• 대한한의학회지
• /
• 제27권1호
• /
• pp.165-183
• /
• 2006

Objectives : We implemented the Artemisia Extract Moxibustion Method and had the clinical tests for the diabetes with it. Methods : We implemented Artemisia extract made by extracting the vasodilator and antioxidant compounds from Artemisia-CH2C12 fraction and the moxibustion method constructed with DC Power supply, controller, Artemisia pad. single and multiple heating terminal with PTC(Positive Temperature Coefficient) thermistor. And we performed to estimate the efficiency on the questionnaire and the clinical tests with 23 cases of the diabetics. Results : We have estimated the improvement over 60% the symptoms that were the upper and lower limbs pain, frequent urination, spontaneous perspiration, thirst, decrease of body weight, and malaise after the moxibustion treatment on 5 cases among 23 cases. And the 19 cases took the biochemical check-up after the moxibustion treatment. From the results of biochemical check-up, the average HbAlc of before treatment was 8.400%, and after treatment 7.632%. The average HbAlc was decreased significantly after treatment (P<0.001). And the average urinary blood of before treatment was 0.73 and after treatment 0.27. The average urinary blood was decreased significantly after treatment (P<0.001). In addition the average FBS before treatment was 182.64 mg/dl, after treatment 161.77 mg/dl. Conclusions : We could estimate that our proposed moxibustion method was a significant treatment method for the diabetes.

• 여성건강간호학회지
• /
• 제7권4호
• /
• pp.536-546
• /
• 2001

The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.

• 대한한의학회지
• /
• 제24권3호
• /
• pp.165-171
• /
• 2003

Objective : Stroke is the second major cause of death in Korea. It is known that the survival and ultimate outcome in stroke depend on various factors, so it is not easy to predict unexpected death in stroke. This study was performed in order to find predicting factors of unexpected death in stroke. Methods : A retrospective study was accomplished by reviewing 21 medical records of stroke patients who expired in the ward of Kyung Hee Oriental Medical Center from January 1998 to December 2001. Data analyzed Were physical examination, laboratory findings, clinical charts and APACH III scoring system. Results : I. The number of unexpected deaths at the ward of Kyung Hee Oriental Medical Center from January in 1998 to December in 2001 were 21 patients (0.1%). 2. Major risk factors of unexpected death were age (${\geq}60$), high blood pressure on 1st admission day and acute stage (${\leq}30{\;}days$). 3. The most frequent time of unexpected death was from 6 a.m. to noon. 4. Major cause of unexpected death was recurrence of stroke (40%). 5. APACH III scores of 75% of unexpected death patients were over 30 points. 6. Clinical change of symptoms 3 or 4 days before the unexpected death were dyspnea, change of urination and defecation. Conclusion; This mortality study suggests that old age, high blood pressure on 1st admission day, acute stage, and high APACH III score are the major predictors of unexpected death in stroke patients and that intensive medical attention is necessary to reach a better outcome.

• 대한간호학회지
• /
• 제24권4호
• /
• pp.597-615
• /
• 1994

This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

• 농촌의학ㆍ지역보건
• /
• 제33권1호
• /
• pp.27-36
• /
• 2008

이 연구에서는 시설참외 농작업자와 수도작 농작업자들의 농부증 유병양상 및 특징을 비교 분석함으로써 시설참외 농작업자들의 농부증 예방을 위한 기초자료를 제공하고자 하였다.연구 대상은 일개 농촌지역에 소재하는 시설참외 농작업자 73명, 수도작 농작업자 87명이었다. 자료수집은 연구자로부터 교육을 받은 면접원들에 의해 수행되었으며 자료는 구조화된 설문지를 이용한 직접면접법을 통해 수집하였다. 조사항목은 일반특성, 건강관련 행위, 농작업 관련 특성, 농부증, 농사일 및 관련 증상 등이었다. 인구사회학적 특성은 시설참외 농작업자에서 수도작 농작업자보다 연령이 상대적으로 낮고 학력 및 소득수준은 높은 것으로 나타났다(p<0.05). 한편, 농작업 종사에 따른 성별, 결혼상태, 동거인 수, 생활행태(흡연, 음주, 운동, 비만) 등의 분포 차이는 없었다. 농작업 종사 경력은 시설참외 및 수도작 농작업자에서 각각 23.4년, 33.9년으로 분포 또한 시설참외 농작업자에서 상대적으로 짧은 것으로 나타났다(p<0.05). 일 농작업 시간은 시설참외 및 수도작 농작업자에서 각각 8.3시간, 6.5시간이었으며, 분포 또한 시설참외 농작업자에서 상대적으로 긴 것으로 나타났다(p<0.05).농부증 총점수는 시설참외 농작업자(5.9)에서 수도작 농작업자(4.6)보다 높게 나타났다(p<0.05). 농부증 유병률은 시설참외 농작업자(38.4%)에서 수도작 농작업자(22.6%)보다 높은 분포를 나타내었으나 유의수준은 경계성(p=0.059)을 나타내고 있었다. 직접표준화 방법을 이용하여 연령을 보정한 결과에서의 농부증 유병률은 시설참외 농작업자에서 수도작 농작업자보다 높은 분포를 나타내었다(p<0.05).농부증 증상은 두 군 모두 어깨결림 및 요통, 야간빈뇨, 수족감각 둔화에서 높은 분포를 나타박종섭, 오경재 9내었으며 특히 어깨결림, 허리통증, 야간빈뇨 등은 시설참외 농작업자에서 수도작 농작업자보다 상대적으로 높게 분포하는 것으로 나타났다(p<0.05).이러한 연구결과로부터 시설참외 농작업자들에서의 농부증 유병률을 예방하고 관리하기 위해서는 상대적으로 과중한 노동강도 및 노동시간에 노출됨을 방지할 수 있는 농작업 환경 개선, 농기구의 개발, 주기적 휴식 및 운동 등의 방안이 다른 농작업보다 적극적으로 마련되어야 할 것이다.Acknowledgement이 논문은 2006년도 원광대학교의 교비지원에 의해서 수행되었습니다.

• 대한간호
• /
• 제29권4호
• /
• pp.51-72
• /
• 1990

The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

• Childhood Kidney Diseases
• /
• 제12권1호
• /
• pp.78-87
• /
• 2008

목적 : 야뇨증에 대한 개념과 인식이 아동이 크면 저절로 낫는다는 과거의 전통적 생각에서 최근 새롭게 바뀌고 있다. 본 연구에서는 야뇨증 환아를 진단하며 치료하는 일차 진료 의사의 야뇨증에 대한 인식에 대해 알아보고자 하였다. 방법 : 2006년 1월부터 2007년 2월까지 대구지역 일차 진료를 담당하는 총 293명의 개원의를 대상으로 설문조사를 실시하였다. 야뇨증의 진단연령, 야뇨증의 원인, 야뇨증과 관련 있는 행동, 야뇨증에 대한 의견, 야뇨증 교육 참석 여부 및 참여의향, 야뇨증의 치료 방법 등에 대해 알아보았다. 결과 : 야뇨증으로 진단할 수 있는 기준 연령에 대한 질문에서는 5-5세로 응답한 경우가 소아 청소년과-비뇨기과 59.2%, 기타 과 49.6%로 전공과목별로 유의한 차이가 있었다. 야뇨증의 원인에 대해서는 "방광이나 신경의 발달이 제대로 이루어지지 않음" 및 "정서적인 문제"를, 야뇨증과 관련있는 행동으로는 "학교나 가정에서 행동이 어수선하며 집중력의 부족을 나타낸다" 및 "소변을 자주 본다."를 대부분에서 응답하였다 최근 5년 동안의 전공과목별 야뇨증 교육 이수 비율 및 야뇨증 교육에 참여할 의향은 소아청소년과, 비뇨기과, 기타 과에서 유의한 차이가 있었다. 야뇨증 환아의 치료 중 약물 요법으로는 이미프라민을 대부분 사용하고 있었으나 데스모프레신은 소아청소년과 및 비뇨기과에서 주로 사용되고 있었다. 야뇨 경보기는 대부분 사용하지 않았다. 결론 : 지역 사회에서 일차 진료를 담당하는 개원의를 대상으로 한 야뇨증 인식의 설문 조사에서 소아청소년과와 비뇨기과 개원의는 야뇨증의 진단 연령에 대한 인식, 야뇨증 교육 이수 및 야뇨증 교육에 참여할 의향이 높았으며 향후 일차 진료 의사를 대상으로 하는 야뇨증의 교육이 더 필요함을 알 수 있었다.