• Title/Summary/Keyword: Interventions

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Existential Issues and Psychosocial Interventions in Palliative Care

  • Lee, Jae-Hon
    • Journal of Hospice and Palliative Care
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    • v.23 no.4
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    • pp.167-171
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    • 2020
  • The finite nature of human existence leads many to search for meaning, which comes into sharper relief for those who are imminently facing death. Therefore, universal existential concerns such as the inevitability of death, existential isolation, loss of meaning, freedom, and dignity are inherent psychological issues in palliative care. Consequently, one of the critical challenges facing palliative care is how to address these issues effectively. This paper provides an overview of common themes of existential concerns and psychotherapeutic interventions to address existential distress among patients in palliative care.

The Analysis of Research Trend on Pediatric Nursing Intervention Studies in Korea, 2000-2011 (국내 임상에서 실시된 아동간호중재 연구논문(2000-2011년) 동향 분석)

  • Bang, Kyung-Sook;Kang, Hyunju;Kim, Miyoung;Min, Sujung;Lee, Sujin;Lee, Haein;Lim, Jihee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.1
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    • pp.24-32
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    • 2013
  • Purpose: The purpose of this study was to analysis the research trends of pediatric nursing intervention studies in Korea form 2000 to 2011. Methods: A literature search was conducted from the databases. RISS and 'Infant', 'Toddler', 'Preschooler', 'Schooler', 'Adolescent', 'Child', 'Effect', 'Program', 'Intervention' and 'Nursing' were used for keyword searches to find relevant studies. A total of 37 published articles and dissertations in Korea from 2000 to 2011 were reviewed using a structured analytical frame. Results: A quasi-experimental design was more common at 91.9% with a true experimental design at 2.7%. The portion of studies in which theoretical framework was suggested was 27.0%. Only 8.1% mentioned International Review Board (IRB) approval and 78.4% received only the participant's agreement. The participants' developmental stage was mostly preschool stage, and 37.0% of the child's health problem was a chronic disease. Sensory interventions made up 45.9% of the types of intervention and most of the sensory interventions were distraction interventions. The contents of intervention outcomes were physiological (54.0%) and psychological (28.0%) categories mostly. Conclusion: This study will help in identifying current research trends of pediatric nursing intervention studies in Korea and provide basic data for the direction of developing pediatric nursing interventions.

Clinical Observation of Changes in Subjective Evaluation Index and Electrogastrography Parameters of Patients with Functional Dyspepsia before and after Oriental Medical Interventions (기능성 소화불량 환자의 한방치료 전후의 주관적 평가지표와 Electrogastrography Parameters를 이용한 객관적 지표의 변화 관찰)

  • Han, Ga-Jin;Kim, Jin-Sung;Ryu, Bong-Ha
    • The Journal of Internal Korean Medicine
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    • v.32 no.4
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    • pp.584-598
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    • 2011
  • Objectives : Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disease. The aim of this study was to analyze the characteristics of functional dyspepsia patients and evaluate changes in symptoms, quality of life, and electrogastrography parameters before and after oriental medical interventions. Methods : We recruited forty-six functional dyspepsia patients who visited gastroenterology clinic in the oriental medicine hospital of Kyung Hee University between November 2009 and February 2011. Patients were assessed for their frequency of dyspepsia (based on short form-Leeds Dyspepsia Questionnaire: SF-LDQ), quality of life (based on functional dyspepsia-related quality of life questionnaire: FD-QoL), gastric motility (based on electrogastrography: EGG) on the first visit. Then, the effect of oriental medical interventions was evaluated using EGG on the second visit. Results : The majority of patients had symptoms of nausea and indigestion. The largest decrease in EGG parameters was found in the indigestion group. The frequency of regurgitation and postprandial EGG power % bradygastria showed a significant correlation. Also, significant correlations were found between some items of FD-QoL and some EGG parameters. Compared to the EGG parameters before oriental medical interventions, some parameters after treatment had positive results, implying the improvement of gastric motility disorder. We also found improvement of EGG parameters in both digestant medicinal group and digestant combined with qi-tonifying medicinal group. Conclusions : The results of this study suggest that clinical application of EGG can be an objective diagnostic tool in functional dyspepsia patients visiting oriental medical hospital.

Timely Interventions can Increase Smoking Cessation Rate in Men with Ischemic Stroke

  • Lee, Min Jeong;Park, Eunjeong;Kim, Hyeon Chang;Lee, Hye Sun;Cha, Myoung-Jin;Kim, Young Dae;Heo, Ji Hoe;Nam, Hyo Suk
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.610-617
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    • 2016
  • Purpose: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. Methods: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. Results: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was $58.25{\pm}11.23$ years and mean initial National Institutes of Health Stroke Scale score was $4.68{\pm}5.46$. The TI group showed a higher point smoking success rate compared with the CC group (p=.003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. Conclusion: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

Effectiveness of Active Warming Intervention for Women Undergoing Cesarean Section: A Systematic Review and Meta-analysis (제왕절개 환자에서 적극적 가온 요법의 효과: 체계적 문헌고찰 및 메타분석)

  • Choi, Jung Eun;Kim, Mee Sun;Song, Jin Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.3
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    • pp.167-180
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    • 2017
  • Purpose: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. Methods: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. Results: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). Conclusion: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.

Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial

  • Misra, Swati;Lairson, David R.;Chan, Wenyaw;Chang, Yu-Chia;Bartholomew, L. Kay;Greisinger, Anthony;Mcqueen, Amy;Vernon, Sally W.
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.3
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    • pp.101-110
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    • 2011
  • Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

The Analgesic Effects of Transcutaneous Electrical Nerve Stimulation and Interferential Currents on the Experimental Cold Pain Model : Frequency 50 Hz and 100 Hz (실험적 냉각 통증 모델에서 경피신경전기자극과 간섭파전류의 진통 효과 비교 : 주파수 50 Hz과 100 Hz)

  • Bae, Young-Hyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4045-4052
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    • 2012
  • The aim of this single blind intervation study was to compare the analgesic effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) on cold-induced pain in healthy volunteers. Sixteen subjects completed six cycles of the cold-induced pain test. During each cycle pain threshold was recorded as the time from immersion of the subject is hand in cold water to the first sensation of pain and pain intensity and unpleasantness ratings were recorded using visual analogue scales. Subjects were randomly allocated to receive each 50 Hz-TENS, 50 Hz-IFC, 100 Hz-TENS and 100 Hz-IFC. Statistical analysis showed that four interventions elevated the cold pain threshold significantly and the difference between interventions was not simply significant. But, no significant differences were identified in pain intensity and unpleasantness ratings. We conclude that there were no differences in the analgesic effects of the four interventions under the present experimental conditions. But, 50 Hz-IFC has been shown to be more comfortable than other interventions.

Simultaneous Comparison of Efficacy and Adverse Events of Interventions for Patients with Esophageal Cancer: Protocol for a Systematic Review and Bayesian Network Meta-analysis

  • Doosti-Irani, Amin;Mansournia, Mohammad Ali;Rahimi-Foroushani, Abbas;Cheraghi, Zahra;Holakouie-Naieni, Kourosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.867-872
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    • 2016
  • Background: Esophageal cancer is one of the most serious malignancies. Due to the aggressive nature of this cancer, the prognosis is poor. A network meta-analysis with simultaneous comparison of multiple treatments can help determine better treatment options that have higher effects on overall survival of patients with lower adverse events. The aim of this review is to simultaneously compare efficacy and adverse events of treatment interventions for esophageal cancer. Materials and Methods: In this review, only randomized control trials (RCT) will be considered for network meta-analysis. All international electronic databases including Medline, Web of Sciences, Scopus, Cochran's library, EMBASE and Cancerlit will be searched to find randomized control trials which compared two or more treatment interventions for esophageal cancer. A network plot will be drawn for visual representation of all available treatment interventions. Bayesian approach will be used to combine the direct and indirect evidence. Treatment effects (e.g. hazard ratio for time to event outcomes, risk ratio for binary outcomes, and rate ratio for count outcomes with 95% credible interval) will be reported. Moreover, cumulative probability of the treatment ranks will be reported using the surface under the cumulative ranking (SUCRA) graphs. Consistency assumption will be assessed by the loop-specific and design-by-treatment interaction approaches. Conclusions: The results of this study may be helpful for the patients, clinicians and health policy makers in selecting treatments that have the best effect on survival and lowest adverse events.

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

  • Zhang, Xiao-Dan;Zhao, Qing-Yu;Fang, Yi;Chen, Guan-Xuan;Zhang, Hui-Fang;Zhang, Wen-Xiao;Yang, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7359-7366
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    • 2013
  • Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

Improving Safety-Related Knowledge, Attitude and Practices of Nurses Handling Cytotoxic Anticancer Drug: Pharmacists' Experience in a General Hospital, Malaysia

  • Keat, Chan Huan;Sooaid, Nor Suhada;Yun, Cheng Yi;Sriraman, Malathi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.69-73
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    • 2013
  • Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. Materials and Methods: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. Results: The mean age of nurses was $32.2{\pm}6.19$ years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from $45.5{\pm}10.52$ to $73.4{\pm}8.88$ out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from $7.6{\pm}5.51$ to $15.3{\pm}2.55$ out of 20 (p<0.001). Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.