• 대한간호학회지
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• 제48권4호
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• pp.389-406
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• 2018

Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.426-432
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• 2012

Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.

• Journal of Genetic Medicine
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• 제13권2호
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• pp.72-77
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• 2016

Purpose: Gaucher disease (GD) is the most common lysosomal storage disease caused by beta-glucocerebrosidase (GBA) deficiency. Oral substrate reduction therapy with miglustat ($Zavesca^{(R)}$) was approved for the treatment of adults with GD type 1, for whom enzyme replacement therapy (ERT) is unsuitable or not a therapeutic option. In this study, we report the effect of miglustat ($Zavesca^{(R)}$) in three Korean GD patients. Materials and Methods: Clinical findings comprising age at diagnosis, presenting signs, laboratory findings at diagnosis, GBA activity and mutations, and clinical courses of the three patients were reviewed. Results: Miglustat was administered to three patients who reported allergic reactions during intravenous imiglucerase infusions. One patient withdrew after 15 months of miglustat administration owing to continuous elevation of disease biomarker levels (chitotriosidase, acid phosphatase, and angiotensin-converting enzyme). Poor adherence to medication was suspected but was denied by the patient. In the other two patients, platelet count and levels of hemoglobin and other biomarkers remained stable during miglustat administration. However, they suffered from severe diarrhea and weight loss, which led to miglustat discontinuation after 1 and 12 months of administration. Conclusion: Our study shows that although miglustat is suggested to GD patients as an alternative treatment to ERT, significant adverse reactions may lead to discontinuation of miglustat. In addition, it is difficult to monitor the drug adherence.

• 성인간호학회지
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• 제12권4호
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• pp.497-506
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• 2000

The purpose of this phenomenological study was to explore and describe the experience of people with HIV/AIDS. Three men and three women with HIV/AIDS participated in the study. They were asked open-ended and descriptive questions in order for them to talk about their experience in their own terms. Interviews were audiotaped and transcribed to maintain data integrity and to reduce perceptual bias. The transcripts were analyzed by the Colaizzi method. Member checks from the participants were used to validate the emergent themes. Seven themes emerged from the analysis. 1. People with HIV/AIDS have a strong impact and emotional reaction when receiving positive HIV test results. 2. All people with HIV/AIDS attempt to conceal HIV infection because of fear of stigma or rejection. 3. After the initial brief traumatic reaction to HIV/AIDS diagnosis, all participants feel lonely because they had no one to express or share their own experiences. 4. People with HIV/AIDS reflect on their life, think about the death and dying process and they become depressed. 5. Most participants feel that the family members who know his/her diagnosis are a big source of support. 6. According to the normativeness of infection route of HIV, the degree of guilty feeling differs among participants. 7. Although all participants think medication is a lifeline, the adherence to medication is not maintained because of side effects, denial and concealment of HIV/AIDS. The results of this study may help nurses and other health care workers to implement more efficient nursing strategies for people with HIV/AIDS by more deeply understanding their experience.

• 한국산학기술학회논문지
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• 제22권6호
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• pp.375-384
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• 2021

본 연구는 조현병 관련 기사에 나타난 키워드와 주요 주제의 변화를 파악하는 의미연결망 분석, 계량적 내용분석 연구이다. 연구대상은 강남역 살인사건 전후 5년간 보도된 조현병 관련 신문기사이다. 수집된 자료는 NetMiner 프로그램 4.4.1을 이용하여 네트워크 통계분석을 시행하였다. 2013년부터 2018년까지 8개 중앙지에서 610개의 신문기사가 검색되었다. 출현빈도가 가장 높은 주요 키워드는 강남역 살인사건 이전에는 '치료', 사건 이후에는 '사건'으로 나타났다. 사건 이전에는 '편견으로 치료시기를 놓치면 만성화 됨', '조기 치료하면 치료가 가능함', '약물치료로 정상적인 생활이 가능함', '심신미약 상태에서 살인 혐의로 기소됨'이라는 네 가지 주제가 도출되었다. 반면, 사건 이후 '여성혐오주의자가 아니라 피해망상이 심해져 살인을 저지름', '약물치료 중단으로 충동적인 행동이 유발됨', '범행 후 심신미약으로 인한 감형을 주장함', '흉기 난동에 출동한 경찰을 살해함'이라는 네 가지 주제가 도출되었다. 이러한 결과는 신문기사가 조현병 및 기타 정신질환자에 대한 편견과 낙인을 줄이기 위해 조현병에 대한 정확한 정보를 제공해야 함을 시사한다.

• 우울조울병
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• 제16권3호
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• pp.134-139
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• 2018

Objectives : Treatment for bipolar disorder is often complicated by various clinical situations. We undertook a survey of expert opinions to facilitate clinical decisions in special situations such as weight gain, metabolic syndrome, hyperprolactinemia, genetic counseling, and treatment adherence. Methods : A written survey that asked treatment strategies related to safety and tolerability, was prepared focused on weight gain, antipsychotic related hyperprolactinemia, lamotrigine related skin rash, treatment non-adherence and genetic counseling. Sixty-one experts of the review committee completed the survey. Results : In the case of weight gain related to medications, experts preferred exercise and education for diet-control. First chosen medications were lamotrigine, aripiprazole and ziprasidone. Recommendations based on expert survey results for treatment of bipolar patients in other special situations are outlined. Conclusion : With limitation of expert opinions, authors hope that results of this study provide valuable information to make clinical decisions about treatment of bipolar disorder in complicated situations.

• 성인간호학회지
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• 제21권5호
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• pp.447-457
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• 2009

Purpose: The purpose of this study was to investigate the level of self management of patients with poorly controlled type 2 diabetes, and to investigate the factors influencing self management. Methods: The subjects consisted of 117 diabetes patients who visited the outpatient department of a university hospital from March to August 2008. Data were collected by asking the subjects to answer a 54-item questionnaire and were analyzed using the SPSS/WIN 14.0 program. Results: The total mean score of the patients in self -management was 4.38 out of 7. Medication adherence obtained the highest score under self-management, and the self-monitoring of blood glucose obtained the lowest score. Family support, self-efficacy, severity, and depression were found to be significantly correlated with self-management. In stepwise multiple regression analysis a total of 44.5% of the variance in self management was accounted for by family support, self-efficacy, severity, and depression. Conclusion: Therefore, a diabetic intervention program should be designed and provided for increasing family support, self efficacy, and severity and for reducing depression of patients with poorly controlled type 2 diabetes.

• 한국전자통신학회논문지
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• 제8권4호
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• pp.611-617
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• 2013

결핵은 꾸준한 복약만 이루어진다면 완치될 수 있는 병임에도 불구하고 우리나라의 결핵 환자 발생률과 사망률은 매우 높은 수준이다. 이러한 상황을 극복하기 위하여 본 논문에서는 결핵과 같은 장기 투약대상자들이 정기적이고 꾸준하게 약을 복용할 수 있도록 하기 위한 스마트 약상자를 개발한다. 개발된 스마트 약상자에는 무게 측정을 통하여 약의 배출 여부를 판단할 수 있도록 0.1g 단위의 정밀한 무게 측정이 가능한 로드셀이 장착되었다. 그리고 무게 측정 결과 근거로 환자가 약을 복용했는지를 판단하기 위한 다양한 시나리오별 알고리듬을 개발하여 소프트웨어로 구현하였다.

• 약학회지
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• 제54권4호
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• pp.282-287
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• 2010

Appropriate drug information is essential in pharmaceutical care practice. In recent years, educating patients with their prescription and drug therapy is becoming an increasingly important aspect of health care. Appropriate drug information has been shown to improve patients' adherence to their medication and the results of pharmacotherapy. The purpose of this study was to study patients' sources of drug information and their preferences in Korea. This study was a 11-questionnaire survey conducted from February 8, 2010 to February 25, 2010. Major sources of drug information used by respondents, proportions of respondents who received drug information on administration, dosage, indication, or warnings and precautions, sources of drug information which patients prefer, and the reasons of their preferences were studied. Of the 303 respondents, the most common sources of drug information were pharmacists (29.7%), doctors (23.8%), and the Internet (17.2%). There were significant differences according to sources of drug information in proportions of respondents who received drug information on administration, dosage, indication, or warnings and precautions. Patients preferred pharmacists as a drug information source the most (38.9%), and the reasons were reliability (72.0%) and easy to use (28.0%). Based on the results of this study, further studies should be conducted to establish the best way to provide appropriate drug information for patients and improve the results of pharmacotherapy.

• 근관절건강학회지
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• 제22권3호
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• pp.245-257
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• 2015

Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.