• Journal of Genetic Medicine
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• 제18권1호
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• pp.38-43
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• 2021

Purpose: Demand for genetic counseling on cancer predisposition syndrome is increasing. We evaluated the psychological effect on counselees after genetic counseling at a clinic in a single center. Materials and Methods: We surveyed a total of 72 enrolled participants who visited a genetic counseling clinic at the Samsung Medical Center (SMC). The initial survey was conducted before the first genetic counseling session, and the second survey was conducted after the second genetic counseling session. A total of 43 participants completed both the initial and second surveys. Results: The initial survey of 72 participants indicated higher feelings of guilt in the group with religion, higher depression and anxiety in the group with a diagnosis of self, and higher anxiety in the group on self-referral to the genetic counseling clinic. In the completed survey of 43 participants, overall decreased depression was observed after the second genetic counseling session (P=0.013). Risk perception and anxiety decreased in the group diagnosed with benign variant/variant of uncertain significance (BV/VUS, 25/3) and increased in the group diagnosed with pathogenic variant (PV, 15). Risk perception and anxiety differed between the BV/VUS and PV groups (P<0.001 and P=0.03, respectively). Conclusion: The genetic counseling clinic at the SMC was effective in ameliorating the depression score. Assessment of survey results revealed different depression scores, feelings of guilt and anxiety, and different effects of the genetic counseling clinic, depending on the subgroups. Understanding the needs and psychological characteristics of different groups is necessary for improving genetic counseling services.

• Clinics in Shoulder and Elbow
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• 제24권2호
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• Journal of Chest Surgery
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• 제54권1호
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• pp.25-30
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• 2021

Background: Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients' knowledge of important parameters of anticoagulant administration. Methods: In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program. Results: Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients' satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group. Conclusion: The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.

• 한국융합학회논문지
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• 제12권8호
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• pp.345-356
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• 2021

본 연구의 목적은 성인 초기 비만인을 대상으로 적용된 중재프로그램의 메타분석으로 중재의 효과를 확인하고, 중재 방법의 특성과 경향을 파악하기 위함이다. 분석 대상 연구는 총 19편으로 SIGN을 사용하여 문헌의 질평가를 실시하였으며, CMA 3.0 및 Revman 5.4을 활용하여 자료 분석하였다. 전체 중재프로그램은 큰 효과크기 (d=-0.76)이며 큰 이질성 (I²=81%)을 보였다. 결과 변수 중 BMI (d=-0.83) 와 체지방률 (d=-0.93)은 큰 효과크기를 보였으며, TG (d=-0.76)와 LDL (d=-0.59)은 중간 효과크기를 보였다. 하위그룹 분석에서 유산소운동, 복합운동, 중강도, 고강도 운동, 1시간 이상의 운동이 효과적이었다. 연구결과를 바탕으로 효과적인 성인 초기 비만인의 중재를 구성할 수 있을 것이다.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.137-146
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• 2022

Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO₂max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO₂max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.81-93
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• 2022

Objectives: The purpose of this study was to develop a model for comprehensively evaluating the risk of sarcopenia in Korean adults and to generate the sarcopenia risk scorecard model based on the results. Methods: The participants of the study were 7,118 adults without sarcopenia in the first basic survey, and a longitudinal analysis was conducted using data from the 1st to 8th survey (2006-2020) of the Korean Longitudinal Study of Aging (KLoSA). The data were analyzed using Rao-Scott chi-square test and weighted Cox proportional hazards regression of complex sampling design. The sarcopenia risk scorecard model was developed by Cox proportional hazards regression using points to double the odds (PDO) method. Results: The findings show that the risk factors for sarcopenia in Korean adults were gender, age, marital status, socioeconomic status, body mass index (BMI), regular exercise, diabetes and arthritis diagnosis. In the scorecard results, the case of exposure to the highest risk level was 100 points. The highest score range were given in the order of age over 65, low BMI, and low socioeconomic status. Conclusions: The significance of this study is that the causal relationship between various factors and the occurrence of sarcopenia in Korean adults was identified. Also, the model developed in this study is expected to be useful in detecting participants with risk of sarcopenia in the community early and preventing and managing sarcopenia through appropriate health education.

• 한국응용과학기술학회지
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• 제40권3호
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• pp.402-411
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• 2023

본 연구는 실봇을 병용한 인지강화 프로그램이 주관적 기억력 저하를 호소하는 노인의 인지기능, 우울 및 치매예방행위에 미치는 효과를 알아보고자 하였다. 대상자는 경기도 성남시에 거주하는 노인 17명을 대상으로 복지관에서 수행되었다. 실봇과 인지강화를 병용한 총 20회기 프로그램을 개발하여 적용하였으며 중재 전과 후에 한국 몬트리올 인지평가(K-MoCA), 우울(GDS), 치매예방행위(DPB)를 평가하였다. 연구결과, 실봇을 병용한 인지강화 프로그램은 노인의 인지기능(t=-4.49, p<.001), 우울(t=2.58, p=.023)에서 통계적으로 유의한 차이가 있었다. 따라서 실봇을 병용한 인지강화 프로그램이 노인의 인지기능 향상 및 우울 완화에 유용한 프로그램이 될 것으로 기대된다.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.182-190
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• 2023

Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.111-127
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• 2023

Objectives: Pre-pregnancy diet has an important role in preparing for healthy generation. However, evidence on this issue has been scarce. A scoping review synthesising current evidence will support the demand to map 'what has been researched' on pre-pregnancy diet and maternal and child health. Methods: Systematic search was performed using PICOS (Population, Intervention, Comparison, Outcomes, and Study design) framework in electronic databases. Articles were screened for eligibility, summarized, and the quality was assessed using the National Institute of Health assessment tool. The review structure complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guide. Results: Forty-two articles were included after full-text screening. Twenty-five studies were in high-income countries (HICs), six in each upper-middle income, five in lower-middle income countries (LMICs), and one in low-income countries (LIC). Based on the regions: North America (n=16), Europe (n=5), South America (n=4), Australia (n=4), Asia (n=5), Middle East (n=2), and sub-Saharan Africa (n=1). The two-most observed diet-related exposures were dietary pattern (n=17) and dietary quality (n=12). The most assessed outcome was gestational diabetes mellitus (n=28) and fetal and newborn anthropometry (n=7). The average quality score±standard deviation was 70±18%. Conclusions: Research related to pre-pregnancy diet is still concentrated in HICs. The context of diet may vary; therefore, future research is encouraged in LMICs and LICs context, and Mediterranean, South-East Asia, Pacific, and African regions. Some maternal and child nutrition-related morbidity, such as anemia and micronutrient deficiencies, have not been discussed. Research on these aspects will benefit to fill in the gaps related to pre-pregnancy diet and maternal and child health.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.32-40
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• 2023

Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL-BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.