The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.
A study has been conducted on developing questionnaires to serve as on site diagnostic tools for the early detection of neuropsychiatric impairment among workers chronically exposed to low-level organic solvents. Two drafts of tentative questionnaires have been developed as follows; several question items were selected from questionnaires which were administered to workers exposed to organic solvents in previous studios and were grouped into each symptom category based on the presence of its association using Guttman scaling method, then these selected items were reviewed by neuropsychiatry specialists. The final draft of the questionnaire (total symptom score=36) was developed by selecting 33 question items which had more than a 0.88 Guttman coefficient of reproducibility in each symptom category from a pilot study in which these tentative questionnaires were administered to workers manufacturing soles. Three plants using organic solvents and one plant never using organic solvents as a control group were selected to test the reliability and validity of the developed questionnaires. The major organic solvent in the workplace environment detected by a personal air sampler and GC/MSD nab toluene. The concentration of toluene in air from the department using organic solvent was statistically different from that of the department never using organic solvent. The concentration of toluene from almost all of the workplace did not exceed the allowable level. There was no statistically significant difference between the concentration of urinary hippuric acid from the workers of the department using organic solvent and that of the department never using it. Total symptom score of the plant never using organic solvents was 9.8 and those of the three plants using organic solvents were 15.6, 14.7, and 13,7 respectively. In order to evaluate the validity of the questionnaires, the workers from two different departments of the plant in which usage of organic solvents are totally dofferemt were compared. The total symptom score was 17.8 for workers of the department using organic solvent and 13.5 for the department never using organic solvent and scores of each symptom group between exposure and non-exposure group also showed statistically significant difference. The finding that total symptom score of the exposure group increased as the duration of employment increased indirectly suggests the usefulness of the developed questionnaire to assess the health effects of chronic exposure to organic solvents. The correlation coefficient, which was calculated to evaluate the test-retest reliability, was 0.581 (p=0.001). The coefficient of Crohnbach which reflects the internal consistency of the questionnaire was 0.91. In conclusion, the reliabilty of the questionnaire was well maintained over the time lapse between the two administrations of the questionnaire and despite the seasonal difference.
Oh, Jae-Young;Lee, Jae-Hon;Han, Sang-Woo;Chee, Ik-Seung;Koo, Bon Hoon;Woo, Jong Min;Yang, Jong-Chul;Gim, Min-Sook;Lee, Sang Hyuk;Heo, Jung-Yoon;Yu, Bum-Hee
Anxiety and mood
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v.10
no.1
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pp.11-16
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2014
Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.
This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.
Lim, Won Sub;Lee, Chang Wook;Lee, Yoon Se;Jo, Min-Woo;Jung, Young Ho;Choi, Seung-Ho;Kim, Sang Yoon;Nam, Soon Yuhl
Korean Journal of Head & Neck Oncology
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v.37
no.2
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pp.43-50
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2021
Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.
Kwon Young Eun;Suh Gil Hee;Kim Kyu-Sung;Choy Haeng-Gi;Jung Moon-Hee
Journal of Korean Public Health Nursing
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v.7
no.1
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pp.67-79
/
1993
This study was designed to identify the general health conditions and high risk factors of the male & female environmental workers. Thereby. the results of this study were to provide useful data as a contribution to knowledge for health protection and promotion. The data used for this study were environmental workers' physical examination cards; the male environmental workers were 52 persons. and the female environmental workers 52 persons. The data were analyzed by descriptive statistics, t-test, Pearson correlation, and distinction analysis, using the SPSS program. The results of this study can be summarized as follows; 1. Thers was a significant statistical difference between the two groups as to height. eyesight. serum GPT, hematocrit. The variables having little difference between two groups were weight. systolic blood pressure. total cholesterol. creatinine. 2. The rate of revealed in significant health examination was extra-health discrimination rate $28.8\%$, significant result of illness rate $12.5\%$. injury-inflicting rate $7\%$. second-time urine test $5.7\%$. antigen positive 3.8%. hearing impairment $2.8\%$, urine protein positive $1.9\%$. and urine sugar positive $1.9%$. 3. The workers diagnosed as extra-health discrimination were 30 persons or $28.8\%$. There was a difference between two groups on the prevalence. In the male environmental workers. ten times live problems and six times pulmonary tuberculosis and three times circulatory problems were revealed the higher than thoes of the female environmental workers. 4. In the male environmental workers, the relationship between age and systolic blood pressure revealed a significant correlation (r=0.22. p<0.05). In the female environmental workers. there was a negative correlation between age and weight (r= 0.25, p<0.05). the relationship between age and total cholesterol correlated positively (r=0.30, p<'0.05). 5. In the male environmental workers, there was a negative correlation between working career and creatinine(r=-0. 22, p<0.05) In the female environmental workers, there was a positive correlation between working career and total cholesterol (r= 0.58, p<0.01). 6. There were significant differences on working career and creatinine accdording to the male and female environmental workers who had any problems through x-ray inspection. 7. There were significant differences on height. eyesight. serum GPT according to the male and female environmental workers who were diagnosed as extra-health discrimination. 8. The female environmental workers who were diagnosed as 'care' were positively correlated with weight (r= 0.26. p<0.05)' and systolic blood pressure (r= 0.30. p<0. 05). on the other hand. the left and right eyesight correlated nagatively(r=-0.15. r=-0.33. p<0.01). 9. The most influential variables on the male and female environmental workers' health condition were working career, height. and weight. And these three variables could help determine the two groups at the level of 81. 8 percentage.
As a basic research material to make more efficient healthcare and health promotion for dental hygienists, this study intends to determine which factors may affect their awareness of occupational diseases. For this sake, this study attempted to investigate into a variety of literatures and data, and applied a questionnaire survey to 160 dental hygienists for about 5 months(from June to October 2003), who were all employed in domestic dental clinics or offices. As a result of analysis, this study can be concluded as follows: (1) The result of analyzing how dental hygienists recognized their occupational diseases showed that 'stiffness in muscle, neck or shoulder due to intensive use of specific physical regions' and 'stress resulting from the attributes of each task' reached the highest awareness(90.6%) of all, which was followed by 'lower eyesight due to detailed or even sophisticated tasks for many hours(65%)' and 'symptoms of ruptured disk due to standing tasks as dental hygienists do for many hours(62.5%).' (2) The result of analyzing how dental hygienists recognize their occupational diseases showed that their awareness averaged 7.28 points out of 14 points, which implies that their awareness of occupational diseases is not very high. Meanwhile, the result of examining how they recognize detrimental or harmful properties of given materials against human body showed that a majority of total respondents(74.4%) regarded given materials as detrimental to human body. (3) The result of examining how dental hygienists recognize their occupational diseases showed that a majority of total respondents(91.9%) identified their own occupational diseases. Many of total respondents(41.9%) pointed out that environmental improvement around workshop in each clinic or office should be foremost prerequisite to health and welfare for dental hygienists. Next, 34.4% of total respondents pointed out the necessity to perform in-house health diagnosis and examination on a regular basis, and 13.1% of total respondents thought it necessary to carry on healthcare education into harmful properties in the aspect of dental materiology, respectively.
Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.
Objectives : This study of oral health problems was conducted to 311 students in Special Schools in order to inquire into the state of their oral health behaviors, to find out the main obstacles against dental services, to secure dental reasonable basis for oral health promotion. Methods : A questionnaire survey was conducted in the Special School of the 311 students in the area of the metropolitan Seoul. By means of Chi-squared test and Fisher's exact test, oral hygiene habits for each type of the subjects, the contents of dental care services, the prerequisites to improve oral health, were inquired. To evaluate the effects to the current oral health status of types of disability, 2-way ANOVA was practiced. Results : The handicapped with Visual impairment, mental retardation, multiplicity with disabilities, answered negatively in their own oral health status. 47.4% of the deaf can do brush for theirselves without the inconvenience, but in other types of disability they showed that they were helped by others. Subjects did not use the secondary oral hygiene necessaries because, except brain damage, almost of types of disability impeded the convenient use. 60 to 88.2 percent of the total respondents were the recent visitors to dental clinique within 1 year, and the most common motives of the visiting dentist, is a routine medical examination, their movements to the dentist in all types of disabilities, needed helps of others. Most of them received medical treatment at a private dentist, the handicapped preferred the private care and place(49.8%). Only in the case of the brain disorders, extremely much of the disabled answered that they were needed the preventive treatment, and the another cases of disability were largely needed the treatment of the decayed teeth. To improve the oral health of the people with disabilities, at the opening of the clinics and hospitals over a certain size, the mandatory medical facilities for the care of the disabled should be preceded and followed by the improvement of dental insurance system so as to reduce the burdens of the cost of dental care. Conclusions : The improvement of oral health policy for the disabled are needed inevitably: Development of secondary oral hygienic easy to use for the disabled, the building systems of medical dental hospital with the disabled facilities, by the improvement of the insurance system, the reduction of the burden of payments.
A non-steroidal anti-inflammatory drug (NSAID) has many adverse effects including cardiovascular (CV) risk. Diclofenac among the nonselective NSAIDs has the highest CV risk such as congestive heart failure, which resulted commonly from the impaired cardiac pumping due to a disrupted excitationcontraction (E-C) coupling. We investigated the effects of diclofenac on the L-type calcium channels which are essential to the E-C coupling at the level of single ventricular myocytes isolated from neonatal rat heart, using the whole-cell voltage-clamp technique. Only diclofenac of three NSAIDs, including naproxen and ibuprofen, significantly reduced inward whole cell currents. At concentrations higher than $3\;{\mu}M$, diclofenac inhibited reversibly the $Na^+$ current and did irreversibly the L-type $Ca^{2+}$ channels-mediated inward current $(IC_{50}=12.89\pm0.43\;{\mu}M)$ in a dose-dependent manner. However, nifedipine, a well-known L-type channel blocker, effectively inhibited the L-type $Ca^{2+}$ currents but not the $Na^+$ current. Our finding may explain that diclofenac causes the CV risk by the inhibition of L-type $Ca^{2+}$ channel, leading to the impairment of E-C coupling in cardiac myocytes.
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