• Title/Summary/Keyword: Mental Health

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The Selection of the Most Painful Word in the Visual Analogue Scale(VAS) for Pain and the Psychosocial Factors in Association with Pain Assessment in Korean Adult Cancer Patients - for the Development of Korean Cancer Pain Assessment Tool(K-CPAT) by Delphi Method - ("표준형 성인 암성 통증 평가도구" 개발을 위한 시각통증등급의 최고통증강도 어휘 및 심리.사회적 평가 항목의 선정 - 델파이 방법을 이용 -)

  • Kim, Jin-Seo;Chun, Byung-Chul;Choi, Youn-Seon;Song, Chan-Hee;Yeom, Chang-Hwan;Lee, Myung-Aha;Lee, June-Young;Yoon, So-Young;Jang, Se-Kwon;Lee, Young-Hee;Lee, Kyoung-Uk;Lee, Chul;Park, Jean-No
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.11-21
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    • 2003
  • This paper addresses the minor differences in the description of pain in Korean language in order to develop a standarized cancer pain aneument tool for Korean adults, Korean Cancer Pain Assessement Tool. The subtle differences in the meaning of expressions used cannot be translated into English and therefore we omiltted the English abstract.

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A Study on the Current State of the Integrated Human Rights of the Elderly in Rural Areas of South Korea (농촌지역 거주 노인의 통합적 인권보장 실태에 관한 연구)

  • Ahn, Joonhee;Kim, MeeHye;Chung, SoonDool;Kim, SooJin
    • 한국노년학
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    • v.38 no.3
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    • pp.569-592
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    • 2018
  • This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.

Correlation between fish consumption and the risk of mild cognitive impairment in the elderly living in rural areas (농촌지역에 거주하는 노인의 생선 섭취량과 인지기능저하 위험도 간의 상관성)

  • Yu, Areum;Kim, Jihye;Choi, Bo Youl;Kim, Mi Kyung;Yang, Yoonkyoung;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.54 no.2
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    • pp.139-151
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    • 2021
  • Purpose: This study examines the correlation between fish consumption and the risk of mild cognitive impairment in the elderly living in rural areas. Methods: The Yangpyeong cohort data collected from Yangpyeong in July 2009 and August 2010 was used as the data set. Adults greater than or equal to 60 years who have completed the Korean version of the Mini-Mental State Examination (MMSE-KC) were selected for the study. After excluding participants with less than 500 kcal of energy intake (n = 2), a total of 806 adults were enrolled as the final subjects. Cognitive function was assessed using the MMSE-KC, and dietary intake was collected using the quantitative food frequency questionnaire comprising 106 foods or food groups. Results: The educational level, proportion of people who exercise, fruits and vegetable intake, and energy intake, tended to increase with fish intake among men, while increasing age resulted in decreased fish consumption. Among women, the educational level, proportion of subjects who exercise, proportion of subjects currently taking dietary supplements, fruits and vegetable intake, and energy intake, tended to increase with fish consumption, whereas increasing age showed decreasing fish consumption. Increased fish intake resulted in a higher MMSE-KC score after adjusting for the confounding variables in women (p for trend = 0.016), but no significant trend was observed between fish intake and MMSE-KC score in men. Fish intake was inversely related to the risk of mild cognitive impairment after adjusting for covariates in women (Q1 vs. Q4; odds ratio, 0.46 [0.23-0.90]; p for trend = 0.009). Conclusion: This study determined that increased fish consumption is correlated with reduced risk of mild cognitive impairment in the female elderly. Further longitudinal studies with larger samples are required to determine a causal relationship between fish intake and cognitive function.

Association of Lifestyle Factors With the Risk of Frailty and Depressive Symptoms: Results From the National Survey of Older Adults (노인의 라이프스타일 요인이 허약 및 우울 위험도에 미치는 영향: 노인실태조사 자료를 바탕으로)

  • Lim, Seungju;Kim, Ah-Ram;Park, Kang-Hyun;Yang, Min-Ah;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.13 no.1
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    • pp.35-47
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    • 2024
  • Objective : This study aimed to investigate the association between lifestyle factors and risk of frailty and depressive symptoms among older South Korean adults. Methods : This study included 10,072 individuals aged 65 or older from the 2017 National Survey of Older Koreans, a cohort of community-dwelling older South Koreans. The following lifestyle factors were assessed: physical activity, nutrition management (NM), and leisure/social activity participation (AP). Frailty was measured using the frail scale and depressive symptoms were measured using the Geriatric Depression Scale. Logistic regression analyses were performed to determine the odds ratios. Results : All lifestyle factors were associated with the risk of frailty and depressive symptoms in the study population. Regular exercise (≥3 times/wk, odds ratio [OR] = 0.59, 95% confidence interval [95% CI] = 0.52~0.91; OR = 0.66, 95% CI = 0.59~0.75), active NM (OR = 0.86, 95% CI = 0.80~0.91; OR = 0.81, 95% CI = 0.76~0.86), leisure AP (OR = 0.79, 95% CI = 0.74~0.84; OR = 0.71, 95% CI = 0.66~0.77) and social AP (OR = 0.92, 95% CI = 0.88~0.96; OR = 0.82, 95% CI = 0.78~0.87) were correlated with lower odds ratios of frailty and depressive symptoms. Conclusion : Adopting a healthier lifestyle characterized by regular exercise, balanced nutrition, and active engagement in various activities can effectively reduce the risk of frailty and depressive symptoms among the older population. Ultimately, this study emphasized the essential role of lifestyle choices in promoting the physical and mental well-being of older adults.

A Study on the Ideal Leadership whole person of Confucian philosophy (유가(儒家)의 전인적(全人的) 지도자상(指導者像) 고찰(考察))

  • Kim, Kyeong-Mi
    • (The)Study of the Eastern Classic
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    • no.62
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    • pp.145-176
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    • 2016
  • This paper aims to define the leadership of Gunja (君子, translated into prince, gentleman, or ideal man) based on Confucian Classics which offer the general values and norms of individuals' virtue and social virtuous acts. Thus, humanitarianism is regarded as true value, and the values of a virtuous person who properly practices social human relationships are discussed. The real worth of Gunja image is discussed as a true human image of "self-completion and completion of all things" (成己成物) which involves the convergence of truth, good and beauty where there is a sense of harmony and balance, where there is stern self discipline and self cultivation and where win-win values of human relationships are created. Confucian saint (聖人), wise man (賢人), great man (大人), and gentleman (君子) mean social leaders. They practice human morals, enlighten and beautify society with teachings, and are indicated as equipped with mental and material harmony, good character and competence, and economic power and morality. People today pursue their own personal growth according to their material preferences rather than pure intellectual cultural values, and are engrossed in visually beautiful external unlimited competition. In this digital age, we are supposed to demonstrate our individuality, but many people are obsessed with appearance, go on severe diet, and lose their health beauty, and consequently suffer mental stress. This trend fuels obsession with appearance and the sick practice of valuing appearance. As an alternative method to overcome this phenomenon, we need a leader image with the convergence of truth, good and beauty, which is characterized by internal self cultivation, external professionalism, and handsome and solid character. Confucian thoughts consist in practicing the Way of disciplining oneself for governing others (修己治人). Self discipline involves developing personal virtuous ability for cultivating a virtuous character, and governing others involves interacting to work together in society and to have right human relationships. Thus, leaders should impress not only themselves but also others. Self discipline for governing others means cultivating virtue for oneself and leading others. A true leader has self introspection and establishes himself through self discipline so that he can govern others or reach the realm of settling others where people live together. As all things have a value and a virtue, humans endeavor to cultivate character and virtue by learning and studying for securing their professionalism, reliability, character and ability, so as to create their own brand value. Personal character does not come from a high position, wealth and power. Character is a personal virtue, and is cultivated as immaculate and fresh through self discipline. As such, it well matches with a clean and clear spirit. This offers the ideal leader as the Guja image who has an extremely humane character, as well as being equipped with inherent virtues of intellect, benevolence and courage. Self development can foster virtue and self management through self leadership and self discipline. The leader in the relationship area can practice his virtue through virtuous acts, in other words, even think from another person's perspective. Such leader is mentioned as the principle of measuring square in the Great Learning. In our viewpoint, the beauty of character can breed the seed of virtue through intellect, benevolence and courage, the beauty of win-win can realize the right virtue by showing exemplary acts to others through considerateness, and the beauty of harmony can love and care for others like me through the principle of measuring square, thereby realizing the universal principle of virtue and harmony, which is like my mind. As such, the ideal leader, when his virtue and mind of being considerate of others all blending well, can exercise his ability to the full, can live together and coexist with many people, and can grow again into a triumphant relationship.

Qualitative Research on Korean Baby-Boomer Generation Middle-Aged Women's Attitude Toward Their Lives - Based on Middle-Class Seoul Residents - (한국의 베이비부머세대 중년여성이 삶에서 추구하는 가치에 대한 질적연구 - 서울 거주 중산층을 중심으로 -)

  • Lee, Ji Hyun;Kim, Sun Woo
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.127-156
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    • 2012
  • A lot of interest in the baby-boomer generation, those who were born after World War II, has emerged since their retirement has been accelerated. The retirement of baby-boomers has caused many health, public welfare, social policy and family relationship problems. However, their increased purchasing power has made them more attractive consumers than any other generation, and they have become a fascinating niche market in the depressed economy. This research selected middle-class women of the baby-boomer generation who have had powerful effects on society and have emerged as an attractive niche market, and attempted to understand their lives intensively. Based on research activities, the purpose of this research is to identify baby-boomer generation middle-aged women's life values. Qualitative research methodology was used to achieve research objectives, and this research aimed to suggest marketing implications to connected industries based on the research results. The research objectives are as follows. 1. understanding the lives of baby-boomer middle-class women who have powerful effects on socio-economic phenomena 2. identifying the life values of baby-boomer middle-class women 3. generating marketing implications based on an understanding of baby-boomer middle-class women's lives and life values This research conducted FGIs(focus group interviews), one of the qualitative research methodologies, to figure out baby-boomer middle-class women's life values intensively and selected 10 women living in Seoul for data collection. The qualitative data of collected FGIs were analyzed with spiral data analysis methodology proposed by Creswell(2007). The most effective factors to influence these middle-class women's lives powerfully were 'time' and 'independence'. Their consciousness of the importance of using time affects their life pattern generally, and their independence also impacts greatly on the way they exploit time and on their diverse relationships. They maximized their self-realization and showed long-term partnership with their surrounding circumstances because of those effective factors. Baby-boomer middle-class women's self-realization was divided into two areas. One was their outside activities and another was perfect management of their physical appearance and home interior. Like the results of this research, their need for social entrance will be reinforced more strongly since their internal and external activities aim for the achievement of self-realization. In addition, this research suggests that baby-boomer middle-class women's activities are connected with their management of their physical appearance and home interior decorations, and that such management is caused not only by a simple interest in fashion and beauty but also a profound desire for self-realization. On account of their consciousness, which is different from other generations, Korean baby-boomer middle-class women are able to maintain positive partnerships with their surrounding circumstances; however, they also show ambivalent emotions to retain effective partnerships. To overcome those stressful situations, they make greater efforts to keep up their health and youth, and also engage in diverse activities to maintain their mental health. Finally, they generate positive attitudes toward their economic situation and extra time to develop self-realization and pursue happy, youthful and healthy lives. Based on those results, this study suggests the following implications. First, industries targeting the baby-boomer generation should develop innovative products and services which help the baby-boomer generation maximize their efficiency of time since time is one of the most important factors powerfully impacting the baby-boomer generation. They will engage in various activities to fill up their extra time and consume helpful products and services. Second, such industries should supply the baby-boomer generation with opportunities which propose new ways of self-realization since this generation shows a great desire for self-realization because of their self-efficacy. With customized strategies of satisfying their needs, the baby-boomer generation would discover opportunities to utilize their abilities, relationships and aesthetic senses, and industries would develop a niche market. Third, market segmentations which target the baby-boomer generation's desire to maintain their physical appearance and home interior should be executed since such activities are the main strategies to develop this generation's self-realization. The baby-boomer generation's desire to study those areas would be expanded, and those education systems should produce innovative products and services targeting the baby-boomer generation. This implication also offers to government officials new policies related with the baby-boomer generation. This exploratory study utilized qualitative research methodology to understand baby-boomer middle-class women's lives, and proposed propositions and limitations for further researches. As for the limitations, first, it is hard to generalize the research results so that they may apply to all areas and economic classes of the baby-boomer generation since this research selected only 10 women living in Seoul for the data collection process. To overcome this limitation, extended data collections of subjects from diverse regions and economic classes should be designed. Second, quantitative research should be conducted to supplement the findings with validities. Third, this research focused on only general ideas of the baby-boomer generation's lives since the range of this study was focused on their overall lives. Therefore, intensive research related to specific areas of their lives should be conducted.

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A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Effects of Total Mixed Fermentation Feeds Based on Rice-straw and Six Forage Crops on the Productivity of Holstein Cows (청예사료작물과 볏짚 위주의 완전배합발효사료 급여가 Holstein 착유우의 생산성에 미치는 영향)

  • Lee, H. J.;Kim, H. S.;Ki, K. S.;Jeong, H. Y.;Baek, K. S.;Kim, J. S.;Cho, K. K.;Cho, J. S.;Lee, H. G.;Woo, J. H.;Choi, Y. J.
    • Journal of Animal Science and Technology
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    • v.45 no.1
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    • pp.69-78
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    • 2003
  • This experiment was carried out to evaluate the value of total mixed fermentation feeds(TMFF) as completely mixed ration and to observe the effect of various kinds of TMFF on the palatability, feed intake, and milk performance in Holstein cows. The dry matter (DM) content of TMFF used in the experiment was 23.98-28.42% range, and CP, TDN, ADF and NDF were 16.2${\sim}$19.2%, 58.3-65.1%, 34.4-39.6% and 46.9${\sim}$49.9% levels, respectively. The relative feed value (RFV) in rape-, alfalfa-, grass-, oat-, corn-TMFF groups were 138.6, 133.9, 116.5, 111.8, 111.4 and 108.1, respectively. Among these groups, RFV of rye-TMFF group was lowest. Dry matter disappearance(DMD) showed 0.8${\sim}$.9% to the all kinds of TMFF groups. The pH was 3.89${\sim}$.87 and $NH_3$-N concentration was 6.93-8.66 mg/$d\ell$. The acetic acid concentration in the raw material of TMFF showed low level of 0.19${\sim}$0.57%, lactic acid showed high level of 1.17${\sim}$3.21% and butyric acid was very high as 0.03${\sim}$0.32%. Therefore, these results provide evidence that the quality of TMFF was not so bad. In the daily fresh matter intake on the alfalfa-, grass-, rape-, corn-, oats- and rye-TMFF were showed 62.85, 60.48, 58.04, 57.11, 54.61 and 45.74 kg respectively. All TMFF showed high palatability as daily dry matter intake of 1.95 to 2.90% by body weight of experimental cows. Body condition score(BCS) was gradually increased in during 60 days of the experiment term. Average daily gain(ADG) showed about 140.0${\sim}$326.7g. In alfalfa-TMFF group, the ADG was higher than in the other groups (p<0.05). Also, the increase in BCS was observed in grass-TMFF group (3.07 to 3.34) and rye-TMFF group was decreased in 3.07 to 3.34 (p<0.05). The milk yield appropriately showed a range of 16.16${\sim}$18.95 kg in all groups. Among these groups, alfalfa-TMFF group was highest(P<0.05). Average milk fat contents showed high levels of 4.06${\sim}$4.79% and the level was high in order of rape-, grass-, corn-, alfalfa-, rye- and oats-TMFF. Milk protein was highest in forage-TMFF and level of lactose in milk was approximately 4.56% in overall groups. Solid non fat(SNF) and total solid(TS) contents were 8.75% and 12.8%, respectively. However, milk composition was not significantly affected by TMFF.

Prediction of Life Expectancy for Terminally Ill Cancer Patients Based on Clinical Parameters (말기 암 환자에서 임상변수를 이용한 생존 기간 예측)

  • Yeom, Chang-Hwan;Choi, Youn-Seon;Hong, Young-Seon;Park, Yong-Gyu;Lee, Hye-Ree
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.111-124
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    • 2002
  • Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

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CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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