• 한국산학기술학회논문지
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• 제18권4호
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• pp.570-577
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• 2017

일개요양병원에 입원한 호스피스 환자에게 제공되고 있는 직종별 호스피스 완화의료 서비스 행위와 빈도를 파악하여 향후 요양병원 호스피스 완화의료 수가 개발의 기초자료를 마련하는데 목적이 있다. 본 연구는 후향적 연구로 요양병원에 사망한 12명의 말기암환자에 대한 의무기록을 자료 로 임종 전 6개월 동안 1개월 간격으로 호스피스 완화의료 서비스 행위를 조사하였다. 직종별 호스피스 완화의료 서비스 행위를 살펴보면 의사는 수혈, 보호자 면담, 투약설명 등, 간호인력은 석션, 산소공급, 환자상태관찰, 투약 간호, 위관영양 등을, 그 외 사회복지사는 개별프로그램적용, 물리치료사는 전기신경자극치료, 영양사는 영양평가와 영양관리, 요양보호사는 식사 및 영양보조, 기저귀교체 등을 수행하는 것으로 나타났다. 조사대상 요양병원을 분석한 결과 요양병원의 호스피스 완화의료 서비스는 미흡한 실정으로 급성기 중환자에게 제공되는 공격적이며 적극적인 서비스가 중심이 되고 있어 편안하고 존엄한 임종 돌봄이 제공되지 못한 것으로 나타났다. 따라서 요양병원에서 제공되는 호스피스 완화의료 서비스 질을 향상시켜 노인들이 삶의 마지막 순간을 존엄하고 평화롭게 맞이할 수 있도록 호스피스 완화의료 수가적용 등의 제도적 방안을 마련할 필요가 있다.

• Journal of Genetic Medicine
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• 제5권1호
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• pp.26-33
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• 2008

목 적 : 페닐케톤뇨증은 상염색체 열성으로 유전되는 아미노산 대사질환으로 PAH와 조효소인 $BH_4$의 활성이 저하되어 발생한다. 본 연구에서는 PAH 유전자 돌연변이와 임상양상과의 연관성을 조사하였고 PAH DNA 변이의 국가간의 차이를 분석하였다. 방 법 : 페닐케톤뇨증 환자와 환자 가족의 동의하에 DNA를 말초혈액의 백혈구에서 분리하여 PAH 유전자를 PCR을 통해 증폭하여 유전자 서열을 분석하였고 PAH 돌연변이가 하나의 대립유전자에서만 발견이 되거나 없는 경우는 분석된 서열을 MLPA를 시행하여 분석을 하였다. 결 과 : 유전자 검사를 시행한 102명의 대립유전자 204개 중 199개의 돌연변이가 발견되어 97%의 검출률을 보였다. 발견된 돌연변이는 총 44가지의 유전자형으로 9개는 novel missense mutation이었고 1개는 novel splice site mutation이었다. 가장 많은 대립 유전자형은 R243Q와 $IVS4^{-1}$G>A로 각각 13.1%와 11.6%를 나타내었다. 전형적 페닐케톤뇨증에서는 R243Q와 $IVS4^{-1}$G>A가 각각 14.2%를 차지하였고 $BH_4$ 반응형 페닐케톤뇨증의 경우에는 R241C가 33.3%, 양성 고페닐알라닌혈증이 R241C가 40%에서 나타났다. $BH_4$ 반응형 페닐케톤뇨증의 경우에는 약물 치료만으로 조절이 되는 환자에서 T278I와 V388M mutation이 발견되었고 약물 치료만으로 조절이 되지 않고 식사요법을 병행해야하는 환자들에서만 K95del과 A447P의 돌연변이가 나타났다. 그리고 2004년 이전에는 동양인에게서 A259T 대립유전자 돌연변이가 발견되지 않은 것으로 보고되었으나 본 연구에서는 10.1%에서 발견되었다. 결 론 : 페닐케톤뇨증과 관련된 새로운 유전자 변이들이 발견되고 있으며 $BH_4$에 반응하는 유전자 변이들의 유전자형들이 확인되면서 PAH 유전자 분석은 페닐케톤뇨증 환자에서 진단, 유전상담, 식사 요법과 치료 계획 수립에 기여할 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권1호
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• pp.6-13
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• 2014

Objectives : The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. Methods : A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. Results : More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. Conclusion : The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권6호
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• pp.326-331
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• 2012

Objectives: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. Materials and Methods: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. Results: The high-risk group (PWI-SF${\geq}27$, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. Conclusion: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6875-6881
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• 2013

Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

• 지역사회간호학회지
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• 제15권1호
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• 대한간호학회지
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• 제47권6호
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• pp.756-769
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• 2017

Purpose: To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life. Methods: A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, $x^2$ test, and t-test. Results: After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p<.001), regular exercise (Z=-4.47, p<.001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p<.001) and sodium intake (t=-4.43, p<.001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol. Conclusion: The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI.

• 한국보건간호학회지
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• 제24권2호
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• pp.237-248
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• 2010

Purpose: The study assessed the effects of a 12-session empowering program to promote health quality of life, decision making self-efficacy, self-care competency, and reasonable medical care utilization among low income women households in one rural area. Methods: A quasi-experimental, one-group pre-posttest design was employed. A total of 28 women enrolled as medicaid recipients in the Public Health Center of W city agreed to participate. The empowering program consisted of 12 sessions addressing health education for self-care of disease, medication management, and counseling for psycho-social support. The intervention was delivered by five nurses and one social worker. Women completed a structured questionnaire measuring the study variables with demographic characteristic before and after the intervention. Data were analyzed by PAWS Statistics 17 utilizing descriptive statistics and paired t-test. Results: After the intervention, significant increases were evident in participant health quality of life (t=-5.83, p<.001), decision making self-efficacy (t=-4.86, p<.001), self-care competency (t=-8.16, p<.001), and reasonable medical care utilization (t=-3.97, p<.001). Conclusion: The 12-session empowering program on health quality of life as well as self-care competency was effective when delivered to low income women households. Further studies with larger numbers of participants and a control group are necessary to validate the results.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.417-426
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• 2001

Objectives : To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. Methods : The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. Results : Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11 - month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. Conclusion : Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

• 치위생과학회지
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• 제23권1호
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• pp.1-12
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• 2023

Background: This study aimed to identify the present level and needs of clinical dental hygienists and to present the Borich needs assessment and the locus for focus model as integrated priorities. Methods: The participants of this study were dental hygienists working in dental clinics (hospitals). The final data of the 194 participants were analyzed using frequency analysis and a paired sample t-test. To analyze the need for clinical dental hygienists to perform work, the Borich priority determination formula was used. The x-y plane consisting of four quadrants was used to analyze the need using the locus for focus model, which helps to determine the priority while showing visual effects. Results: "Scaling" was the highest required level for clinical dental hygienists, and "panorama taking" was the highest present level. The priorities of educational needs were systematically and visually derived from dental hygienists who were currently working through the Borich needs assessment and the locus for focus model for each task performed in the clinical field. Through the priorities of these two models, a total of 13 items appeared in the common high-level area; "oral health care (disability)," "oral health care (systemic disease)," "applying a rubber dam," "professional mechanical tooth cleaning," "root planing," "taking vital signs," "medication counseling," "wire cutting," "removing cement after removing band/bracket," "delivering bracket," "preparing mini-screw implantation," "dental insurance claim," and "patient reception." Conclusion: Based on the results, the department of dental hygiene should maintain and improve the standardized clinical practice curriculum and clinical dental hygienists' practical skills and contribute to the realization of the legal scope of dental hygienists, reflecting the requirements of clinical fields.