Purpose: This study was done to develop a internalized stigma reducing program based on cognitive-behavioral therapy and appropriate for patients with schizophrenia and to evaluate its effectiveness. Methods: The study design was a mixed method research. Qualitative study, 13 patients with schizophrenia who had experience in overcoming stigma were purposively chosen for interviews and data were analyzed using Giorgi method. Quantitative study, 64 patients with schizophrenia (experimental group =32, control group =32) were recruited. The cognitive-behavioral therapy-based program for reducing internalized stigma in patients with schizophrenia was provided for 8 weeks (12 sessions). Data were collected from June. 20, 2013 to Feb. 14, 2014. Quantitative data were analyzed using ${\chi}^2-test$, t-test, repeated measures ANOVA with the SPSS program. Results: Qualitative results, from the experience of coping with stigma in patients with schizophrenia seventeen themes and five themes-clusters were drawn up. Quantitative results showed that internalized stigma, self-esteem, mental health recovery and quality of life were significantly better in the experimental group compared to the control group. Conclusion: Study findings indicate that this program for reducing internalized stigma in patients with schizophrenia is effective and can be recommended as a rehabilitation program intervention to help patients with schizophrenia to cope with internalized stigma.
Puerperants need postpartum care for the recovery to the condition before pregnancy. The postpartum care used to be done at home however, nuclear families and the industrialization of society brought postpartum care home, postpartum care home has two major problems; first, there is no rules and regulations for postpartum care home. Second, no reasonable guidelines of postpartum care home exist. This study inquires into those problems and directions of legalization and reasonable guidelines of postpartum care home. In sum, the legal system for the postpartum care home has to be built and the supervision has to be done by the specialist, in particular, by the oriental medical doctor. The postpartum care home should be supervised for the healthy rehabilitation of puerperants mental, social health as well as their bodies. Also the neonate that has wick immune system requires special care for the prevention of infection and for the adaptation to the environment.
This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.
Purpose: The aim of this study was to investigate the differences in emotional response and coping pattern by age among cancer patients. Method: As descriptive research, from November 2000 to April 2001, data was collected with semi-structured questionnaire to 90 adult cancer patients, and analyzed using quantitative analysis. Result: Most emotional response at the time of diagnosis of cancer is despair in 20-39years & more than 60 years, and Impact in 40-59years. In emotional response during treatment by age, there were most much hope in 20-39 years, fear in 40-59years, and acceptance in more than 60years. In difficulties by age during treatment, there were most much mental burden in 20-29years, problems about occupation/finance in 40-59years, and physical discomfort related to treatment in more than 60 years. Resolution of difficulties of treatment shows avoidance in 20-39years, active participation in 40-59years and compliance in more than 60 years. Coping pattern during treatment was positive thinking in 20-39years, refreshment in 40-59years, and despair/avoidance in more than 60 years. Coping with treatment & progress shows in 20-39years maintenance of current health, 40-59years impossible to recover, more than 60year health recovery. Conclusion: Nursing could be considered emotional response and coping pattern according to age.
In this study we tried to give a decision on propriety of working conditions, to present ideas on reducing work loads. and to grope for efficiency of agricultural works. For this we examined the actual conditions of working environment, farmer's clothes, working posture, working methods, working time, resting state, fatigue recovery methods during cultivating lettuce in the winter greenhouse. And Ive improved harmful factors that affect farmer's health by considering results of previous study and farmer's subjective sensation. And we measured, compared, and analyzed the farmer's work loads before and after improvement. The results of this study are as follows ; 1. According to examine the actual conditions of cultivating lettuce in the winter greenhouse, farmers have experienced physical and mental chronic fatigue on the basis of the hot and humid crops-centered working environment, the rough ground condition, inconsistent arrangement of working stand and sorter, heavy-weared habits. and unsuitable working posture. 2. When we improved harmful factors that affect farmer's health, conformed the positive effects on important work efficiency index such as heart rate, electromyovolume, body temperature, and microclimate inside clothing and work loads were decreased by improving the hot and humid working environment, eliminating the hillock and obstacles of working path. deliver way, arranging the working stand and sorter consistantly, decreasing the clothing weight, improving the working postures and methods as using assistant appliances, alloting the working time and sequence effectively and presenting the light gymnastic exercises and rest for fatigue restoration.
A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.
Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.
Purpose: The purpose of this study is to identify the effect of the disease duration on depression change in cancer survivors between the middle and old age groups. Methodology: To that end, we analyzed 275 patients using the Korea welfare panel survey from 2011 to 2016 jointly developed by the Korea Institute for Health and Social Affairs and Seoul National University. The duration of the elapsed and the experienced was measured as a independent variable. CES-D was used as a dependent variable. Frequency, paired t-test, ANOVA, and logistic regression analysis were conducted using Stata 14.0 for statistical analysis. Findings: Studies have shown that as the duration of the elapsed and the experienced increases, people under 65 are 1.17 times and 1.84 times each more likely to be included in depression-increase group than in depression-reduction group. The group that has been maintaining economic activities continuously since 2011 was significantly less likely to belong to the depression-increase group than the group that did not have economic activities in 2016. For those aged 65 and older, there was no significant difference in the duration of the elapsed and the experienced. The higher the likelihood of low-income households being included in the family of depression was 2.58 times higher than for ordinary households. Practical Implications: It is suggested that close policy management of the employment and working environment of cancer survivors is necessary, as both cancer survivors of productive age as well as older cancer survivors are analyzed to be beneficial to depression management. In addition, a systematic management program related to the mental health of cancer survivors is believed to be necessary for normal social recovery in the future.
Objectives: The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve health-related quality of life (QOL), and increase satisfaction with the hospital. Methods: Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05. Results: The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate. Conclusions: While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.
Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.
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