• Journal of Korean Academy of Nursing
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• v.20 no.1
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• pp.88-117
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• 1990

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.12
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• pp.292-300
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• 2016

The purpose of this study was to investigate the effects of case-based learning about infants and toddlers on healthcare department students, using a video in an emergency care environment. A total of 57 students from a healthcare department of D university in J city were enrolled. They were divided into two groups: The experimental group (n=29) and the control group (n=28). This study is pre-post designed with a non-equivalent control group. The experimental group received a 1-week education for a duration of 3 weeks (3 sessions in total) with 180 minutes per session. The control group received a traditional curriculum of lecture. Before and after the education, we measured the knowledge and skill confidence of emergency care toward infants and toddlers, the academic self-efficacy, and problem solving ability. Data collection and intervention were carried out from November to December of 2014. Data were analyzed with x2-test, paired t-test, unpaired t-test with SPSS version 20.0 Program. The experimental group showed a significantly higher improvement of skill confidence of emergency care toward infants and toddlers (P<001), as well as preferred task difficulty among sub-items of academic self-efficacy (p=.029), approach avoidance style (P=.001), and problem solving confidence (p=.040) among sub-items of problem solving ability on preference compared with the control group. In this study, a case-based learning was verified to be an effective teaching method to enhance professional competency of healthcare department students. The findings from this study suggest that a case-based learning using various educational contents should be developed, expanded, and carried out to promote better learning.

• Journal of the Korean Society of School Health
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• v.10 no.2
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• pp.271-283
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• 1997

This study is designed for the school health education, contributing experience of life from middle school students from broken homes by describing specifically what they go through. And on this basis this study works out a grounded theory on the experience of life for middle school students from broken homes. The data was collected through a series of interviews with nine subjects singled out at each stage of research. With the permission of the subjects, the interviews were recorded and transcribed. The interviews lasted from 30 minutes up to one hour and 20 minutes. The in-depth interviewing methods and observations was used for data collection. The data was analyzed in the framework of grounded theory as mapped out by Strauss & Corbin (1990). By analyzing the materials eighty-three concepts were extracted, and they were united into 21 subordinate categories through the course of analysis. These were classified into nine precedence categories. The core category was found to be the adaptation of 'Wichookdem" or "Shrinkage". "Shrinkage" widows experienced was showed as the results "Self-reliance" and "Overcoming" through the course of generation and reaction, confrontation, and adaptation. According to the analysis findings of materials, the central phenomenon was showed as "shrinkage", the causal condition as "surprise", "Darkness", "Grudge", "Desolate", "Empty". The veins as presence of those around people and existence of support, and the meditate situation as self-support. For the strategy in solving "shrinkage", preparations of countermeasure and self-reinforcement were showed. And self-reliance and overcoming were the results. Through the contrast to the cases of ground materials, relation statements as follows were induced; (1) The weaker the suffering is, the weaker the "shrinkage" tends to be. (2) The stronger the suffering is, the stronger the "shrinkage" tends to be. (3) The more frequent and serious the suffering, the stronger the "shrinkage" tend to be. (4) The more infrequent and not serious the suffering is, the weaker the "shrinkage" tends to be. (5) The weaker the "shrinkage" is, the more self-control1ed the responses tends to be. (6) The stronger the "shrinkage" is, the more impulsive the responses tends to be. (7) The more satisfying the support is, the more self-controlled the responses to the "shrinkage" tends to be. (8) The more dissatisfying the support is, the more impulsive the responses to the "shrinkage" tends to be. (9) The more concrete the type of support is, the more self-controlled the responses to the "shrinkage" tends to be. (10) The more superficial the type of support is, the more impulsive the responses to the "shrinkage" tends to be. (11) The more self-controlled the responses are, the more self-reliant the subjects tends to be. (12) The more impulsive the responses are, the more conflict and wandering the subjects tends to be. (13) Whether the responses to the "shrinkage" express themselves in self-control or an impulse, it will be resulted in the form of either tension or pain. The following two were confirmed on the basis of repetitive relations; (1) If a subject's suffering is weak, infrequent and not serious, the "shrinkage" is weak. Also the subject's support is highly satisfying, and the support type is concrete. The responses to the "shrinkage" result in self-control which consequence is self-reliance with part. of it resulting in tension and pain. (2) If a subject's suffering is strong, frequent and serious, the "shrinkage" is strong. Also the subject's support is dissatisfying, and the support type is superficial. The responses to the "shrinkage" result in an impulsion whose consequence is wandering with part of it resulting in tension and pain. Through the results in this study, the following is to be suggested; O This research is basically aimed at analyzing the experience of the middle school students living in broken homes, for the more inclusive approach, the study for them is made systematically according to the type of their problems.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.90-103
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• 1996

The purpose of this paper is to compare two approach to assessment of coping patterns. The sampling method was a purposive sampling technique. The study participants were out patients 113 of rheumatoid arthritis center of one University hospitals in Seoul. Datas were collected from Nov. 13 to Nov. 24, 1995. The instruments used for this study were Graphic Rating Scales of pain, The Beck Depression Inventory and Coping Patterns tool. The collected data were analyzed for frequency, means, SD, factor analysis., Pearsons' correlations and ANOVA. The results were summerized as follows ; 1. When raw scores were used : there were not correlation in all three coping patterns. 2. When relative scores were used : there were significantly correlated in all three coping patterns. 1) Active coping and Positive-cognitive coping (r=-0.352, p< 0.0001) 2) Positive-cognitive coping and Negative-cognitive coping (r=-0.594, p< 0.0001) 3) Active coping and Negative-cognitive coping(r=-0.544, p< 0.0001) The results of this research with relative scales provided more insight into the correlation in all three coping patterns. 3. Pearsons' Correlations were computed for each coping pattern, age, pain level, duration of pain and BDI. 1) Using raw score : (1) Active coping was significantly related to pain level(sensory score ; r=0.268, p<0.05, affective score ; r=0.266, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r=-0.252, p< 0.05), pain level (sensory score ; r= -0.244, p< 0.05) (3) Negative-cognitive coping was significantly related to depression level (r=0.312 p< 0.0001). 2) Using relative score (1) Active coping was significantly related to pain level(sensory score ; r=0.299, p<0.05, affective score ; r=0.246, p< 0.05) (2) Positive-cognitive coping was significantly related to age (r= -0.187, P< 0.05), pain level (sensory score ; r=-0.317, p<0.0001, affective score : r=-0.305, p<0.0001) and depression level(-0.339, p<0.0001)) (3) Negative-cognitive coping was significantly related to depression. level(r=0.313, p<0.0001). 4. When raw and realtive coping scores were compared to those of age groups, religious groups and BDI level(high, middle, low) ; 1) Using raw score : (1) Active coping : there were not significantly difference (2) Positive-cognitive coping ; 20-39 age group and 50-59age group had significantly higher scores than over 60age group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping : 20-39age group and over 60age group had significantly higher scores than 40-49age group. Non-religious group had significantly higher scores than christian group. BDI-high level group had significantly higher scores than other groups. 2) Using relative score : (1) Active coping : over 60 age group had significantly higher scores than 20-39 age group and 40-49age group had significantly higher scores than 20-39 age group (2) Positive-cognitive coping ; 40-49age group, 20-39age group and 50-59age group had significantly higher scores than over 60age group. Christian group had significantly higher scores than non-religious group. BDI-low level group had significantly higher scores than other groups. (3) Negative-cognitive coping ; Non-religious group had significantly higher scores than christian group and buddhistic group. BDI-high level group had significantly higher scores than other groups. The current data suggest that relative scores may yield a different perspective on coping patters than raw scores. The use of relative scores reveals the relation clearly, without its being blurred statistically by the effect of other coping strategies or being relegated to a partial correlation. The use of relative scores holds promise for delineating the relations between ways of coping and health-related behavior.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.94-101
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• 2018

Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

• Journal of Digital Convergence
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• v.12 no.8
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• pp.369-376
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• 2014

Death education the subject of interest is the subject of the medical staff for the death of stress degree and acceptable approach to analyze the death centered on the hospital space education in order to take advantage of From April 2014 until April 30, 281 people who lived Daejeon were surveyed. Analysis of the results, if they are taken the death education, it was considered more important than none education. If Patient in an unrecoverable state, to the question of who to notify, guardian had the highest score. Suitable for end-of-life include home, healthcare, social welfare facilities in order. When you take advantage of the results, In order to understand and take care of the phenomenon of death, we accommodate health and medical treatment perspective, humanity perspective, social perspective. It is Study for Death education program that can be applied to public. It is significant as a basis material to popularize and generalize death education program.

• Molecules and Cells
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• v.38 no.6
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• pp.528-534
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• 2015

Hypoxia-inducible factor (HIF) is a key regulator of tumor growth and angiogenesis. Recent studies have shown that, BIX01294, a G9a histone methyltransferase (HMT)-specific inhibitor, induces apoptosis and inhibits the proliferation, migration, and invasion of cancer cells. However, not many studies have investigated whether inhibition of G9a HMT can modulate HIF-$1{\alpha}$ stability and angiogenesis. Here, we show that BIX01294 dose-dependently decreases levels of HIF-$1{\alpha}$ in HepG2 human hepatocellular carcinoma cells. The half-life of HIF-$1{\alpha}$, expression of proline hydroxylase 2 (PHD2), hydroxylated HIF-$1{\alpha}$ and von Hippel-Lindau protein (pVHL) under hypoxic conditions were decreased by BIX01294. The mRNA expression and secretion of vascular endothelial growth factor (VEGF) were also significantly reduced by BIX01294 under hypoxic conditions in HepG2 cells. BIX01294 remarkably decreased angiogenic activity induced by VEGF in vitro, ex vivo, and in vivo, as demonstrated by assays using human umbilical vein endothelial cells (HUVECs), mouse aortic rings, and chick chorioallantoic membranes (CAMs), respectively. Furthermore, BIX01294 suppressed VEGF-induced matrix metalloproteinase 2 (MMP2) activity and inhibited VEGF-induced phosphorylation of VEGF receptor 2 (VEGFR-2), focal adhesion kinase (FAK), and paxillin in HUVECs. In addition, BIX01294 inhibited VEGF-induced formation of actin cytoskeletal stress fibers. In conclusion, we demonstrated that BIX01294 inhibits HIF-$1{\alpha}$ stability and VEGF-induced angiogenesis through the VEGFR-2 signaling pathway and actin cytoskeletal remodeling, indicating a promising approach for developing novel therapeutics to stop tumor progression.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.12
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• pp.8525-8534
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• 2015

The purpose of this study was to investigate relations among the Health Promotion Behavior, Physically, Psychological, and Social factors of the stroke patients. The subjects include the patients that were Stroke was diagnosed and being admitted to hospital. The data of total 223 stroke patients were used in analysis. Collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation, and Structural Equation Analysis. As a result, The higher medical support health promotion behavior scores were higher. Health Promotion Behavior had correlations with the subjective health state(r=.56, p=.000), family support (r=.68, p=.000), medical support(r=.65, p=.000), Fatigue(r=.27, p=.004), and behavioral intentions(r=.75, p=.000). Factors Affecting Health Promotion Behaviors of the Stroke patients Physically factors of(${\beta}$=-.156, p=.014), Psychological factors of subjective health(${\beta}$ =.283, p=.001), behavioral intentions((${\beta}$=.362, p=.000), Social factors such as family support(${\beta}$=.219, p=.010), the medical support(${\beta}$=.246, p=.004) was found to be significant influence factors. In conclusion, health promotion behavior in stroke patients is subjective health, behavioral intentions, a family support. The higher medical support health promoting behavior appears score was found to be highly Psychological factors and social factors are important factors in promoting healthy behavior. Therefore, psychosocial personalized approach to maintaining the stroke health promotion, health promotion action program itdaneunde be used as basis for relapse prevention is significant.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.197-208
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• 2017

The purpose of this study was to construct and test a structural equation model for college student's gambling behavior. A structured questionnaire was completed by 246 college students to analyze the relationships between perspective factors(irrational gambling belief), psychological factors(depression, anxiety), social factors(parental monitoring, parental support, friend support), self-control and gambling behavior. The moderating effects of gender, friends and family's gambling behaviors were examined. The data were analyzed using SPSS 21,0 and AMOS 20.0 programs. Self-control and psychological factors directly affected the college student's gambling behavior, while perspective factors and social factors affected it indirectly. The model fit indices of the modified model were suitable for the recommended levels. The overall study findings suggest the need to develop a gambling prevention program for college students that reinforces self-control, parental monitoring and support, and friend support while reducing irrational gambling belief, depression, and anxiety. An approach that considers gender and a development of a group counseling program for family or friends are also required.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7143-7147
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• 2013

Background: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. Objective: This study aimed to explore the decision making experiences of women with early breast cancer. Materials and Methods: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. Results: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. Conclusions: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.