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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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An Analysis on Changing Pattern of Economic Active Population by Working Life Table for Korean Men (우리나라 노동생명표에 의한 노동력추이 분석)

  • 조진만
    • Korea journal of population studies
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    • v.13 no.2
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    • pp.1-18
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    • 1990
  • This is a study which attempt to analyze changing patierns of economic active popu-lation, t o estimato- future patterns, and exa- mine vartons problems arises by changing c ire u mst ances of t he labor force market in- clunging soici al, economic ic, heathl th and demoi-graph ic aspects. We have constructed series of wotking life table which are useful in syt uiolyioig the lirocess of growth and structural change of labor force. Work i ng life tables represent ihie life eyele of econrmic' activity in hi ypothetical cohorts, that is. gen-erat i on of men Sn bject at eat' b period ot f their lives th given ra to's o mor tali it y and of par-- tici pation in economic activities. The tabloes prot' ide measorues of the alvet'age he ng t able of economically aeti \- e life. and agespecific rates of en trannee' into and retirement from the hahn' force. In const routing working life tables, age-specific activity rates and life tabole popula- titoto which represents contemporary condi-tions of moortality in Korea au'e the basic' maltoerials. We have derived the age-specific rates foorm economically active population survey, whoich were conducted by the Bureau of Statistics, Economic Planning Borard of the Korean government. Working life tables are constructed for men wtable these materi- als in the year of 1970, 1980 and 1988 by a modified Wolfbein-Wool's method. Some of the findings may be summerized as follow : 1) A central part of constructing working life table is calculation of stationary' economic active population, which represents the number of men in the stationtary population extoected to be in the labor force at each age group in the life span. The stationary economic active population by age have generally a universal pattern, where they rise sharply in the early twenties, approach its' peak in the thirties decline thereafter. at first graolually and then more rapidly at an advanced age. Korean men show the same general pa ttern of age distribution of stationary eco-- nomic active population with sharp increase hegining from the age interval of 20 to 24, reaching to maximum level at older age. The population. however, presumably, increased substantially due to increaseing school atte endance rates. Another difference exiSts in the youngest age groups, that is the activity rate in the year of 1988 is lower than that of Japan. The table shows an analysis of changes in the age distrihution of labor force between 1970, 1980 and 1988. 2) It was shown an analysis of changes in the age distribution and cause of separation from labor force. The entrance rate to labor force has increased from 18~\5 persons to 299 persons per 1000 head of stationary population between that of 1980 than that of 1988 for Korean men in 20~24 age group. The entrace rate to labor force shows a rapid entrance appearance concentrated on the 15~24 age group. The separation rate from labor force by retirment in Korea in the year of 1988 shows a great difference of the about four times as much as that of Japan. 3) The functions of table illustrate the patterns of working life of males in Korea in 1970, 1980 and 1988. The average remaining number of economically active years, e at age 15 in 1988 is 46.39 which is 2.12 years of increase compared with that of at age 15 in 1970,1980 and 1988 are 43.90,44.27 and 46.39 respectively, showing steadily increase dur- ing the past double decade the increase in the length of economically active life various age may be considered to have come both from extention of general life expectancy and from increasing entrance rate to economic activity in high age that of working is far greater in 1988 than that of 1980. The gaps between expectation of life and average remaining years of economically active widened due to rapid improvement of mortality level in Ko- rea. This observation together with the population pressure by the appearance of a group of younger population implies that constant increase of economically inactive population among older age group.

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Development of Dual Reporter System of Mutant Dopamine 2 Receptor ($D_2R$) and Sodium Iodide Symporter (NIS) Transgenes (변이 도파민 2 수용체와 나트륨 옥소 공동 수송체 이입유전자의 이중 리포터시스템 개발)

  • Hwang, Do-Won;Lee, Dong-Soo;Kang, Joo-Hyun;Chang, Young-Soo;Kim, Yun-Hui;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.4
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    • pp.294-299
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    • 2004
  • Purpose: Both human NIS and mutant $D_2R$ transgenes are proposed as reporting system in transplanted cell tracking. Using hepatoma cell lines, we constructed a dual reporter system containing human sodium-iodide symporter (hNIS) and dopamine 2 receptor ($D_2R$) and compared its characteristics. Materials and Methods: The recombinant plasmid ($pIRES-hNIS/D_2R$) was constructed with IRES (internal ribosome entry site) under control of the CMV promoter $pIRES-hNIS/D_2R$ was transfected to human hepatoma SK-Hep1 cell line with lipofectamine. HEP-ND ($SK-Hep1-hNIS/D_2R$) cells stably expressing hNIS and $D_2R$ was established by selection with G418 for two weeks. RT-PCR was performed to investigate the expression of both hNIS and $D_2R$ genes. The expressions of hNIS and $D_2R$ were measured by $^{125}I$ uptake assays and receptor binding assays. Specific binding of $D_2R$ to $[^3H]spiperone$ was verified by Scatchard plot with (+) butaclamol as a specific inhibitor. $K_d\;and\;B_{max}$ values were estimated. The correlation between hNIS and $D_2R$ expression was compared by using each clone. Results: Similar quantities of hNIS and $D_2R$ genes were expressed on HEP-ND as RT-PCR assays. HEP-ND cells showed 30 to 40 fold higher radioiodine uptakes than those of parental SK-Hep1 cells. $^{125}I$ uptake in HEP-ND cells was completely inhibited by $KClO_4$, a NIS inhibitor Specific binding to HEP-ND cells was saturable and the $K_d\;and\;B_{max}$ values for HEP-ND cells were 2.92 nM, 745.25 fmol/mg protein and 2.91nM, 1323 fmole/mg protein in two clones, respectively. The radioiodine uptake by hNIS activity and $D_2R$ binding was highly correlated. Conclusion: We developed a dual positron and gamma imaging reporter system of hNIS and $D_2R$ in a stably transfected cell line. We expect that $D_2R$ and hNIS genes can complement mutually as a nuclear reporting system or that $D_2R$ can be used as reporter gene when hNIS gene were used as a treatment gene.