• Title/Summary/Keyword: Outpatient Disease

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Effect of a Telephone-administered Cognitive Behavioral Therapy for the Management of Depression, Anxiety, and Chronic Illness Anticipated Stigma in Parkinson's Disease (파킨슨병 환자의 우울, 불안 및 만성질환에 기대되는 낙인 중재를 위한 전화사용 인지행동치료 효과)

  • Bae, Eun Sook;Yeum, Dong Moon
    • Korean Journal of Adult Nursing
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    • v.27 no.2
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    • pp.223-232
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    • 2015
  • Purpose: Parkinson's disease (PD) has a high incidence of psychiatric comorbidity, specifically depression and anxiety. This study examined the effectiveness of group cognitive behavioral therapy (CBT) in treating depression and anxiety. Methods: The study included 42 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression and anxiety. Patients were attending a department of outpatient neurology at D University Schools of Medicine in B Metropolitan city. A structured telephone-administered cognitive behavioral therapy was conducted for eight weeks. A repeated measure ANOVA was used to analyze results at pretest, post-test, and four weeks follow up. Results: According to service method, there were significant differences between the two groups in depression, anxiety and stigma was significant difference between time (p<.05). Analysis of the interaction between time and service method revealed significant differences in depression and anxiety (p<.05). Conclusion: The results suggest that telephone-administered cognitive behavioral therapy may be effective and may provide opportunity to adapt to individual needs for treating depression and anxiety in patients with Parkinson's disease.

The Factors That Related the Dietary Behavior in Coronary Artery Disease Patients (관상동맥질환자의 식이이행과 건강신념, 사회적 지지 및 특성 간 상관관계)

  • Lee, Ju-Im;Han, Sang-Sook
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.25-32
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    • 2005
  • Purpose: This study was aimed to identify the factors that related the dietary behavior in coronary artery disease patients and to made the data for nursing which is thought to improve the dietary behavior. Method: The study population was the coronary artery disease patients who were treated at outpatient base. The study method was the dietary behavior, diet self-efficacy, perceived-healthy behavior, social support measurement & characteristics. All of the above tool was validated for its composition propriety and confidence. The statistical analysis was done by SPSS PC 11.0 program. and frequency, percentage, mean, standard deviation, Pearson's correlation was used for analysis. Results: The score of dietary behavior in the coronary artery disease patients was 4.57 point. The score of perceived-benefits was the highest among the association factor(point) and the score of perceived-barriers(m=2.78), diet self-efficacy(m=5.12), social support(m=4.86 point), exercise and chest pain. Conclusion: The development of the program for the efficient dietary education that prevents the progression of the coronary artery disease is needed.

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Psychological Intervention Effects of Group Music Therapy on Patients with Parkinson's Disease (파킨슨병 환자에 대한 집단 음악요법의 심리적 중재 효과)

  • Bae, Eunsook;Kim, Mijung
    • Research in Community and Public Health Nursing
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    • v.27 no.2
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    • pp.153-162
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    • 2016
  • Purpose: Music therapy is a non-pharmacological treatment of the behavioral and psychological symptoms. This study was conducted to contribute to the rehabilitation of patients with idiopathic Parkinson's disease in the areas of functionality, emotionality and sociability. Methods: The study included 35 participants, aged between 52 and 77 years, who were diagnosed with idiopathic Parkinson's disease (IPD) and reported suffering from depression, chronic illness anticipated stigma, and worrying about quality of life. The patients were recruited from the department of outpatient neurology at School of Medicine, D University in B Metropolitan City. Group music therapy was performed for nine weeks. The results were analyzed by repeated measures ANOVA. Results: In terms of stigma, there were significant differences between two groups and time (p<.05). Analysis of the interaction between time and service method revealed significant differences (p<.05). Between time, and the interaction between time and service method revealed significant differences in terms of quality of life (p<.05). Conclusion: The results suggest that group music therapy will be effective on the psychosocial well-being of patients with Parkinson's disease living in assisted and independent living communities.

Predicting Factors on Eating Behavior in Coronary Artery Disease Patients (관상동맥질환의 식이이행 예측 요인)

  • Han, Sang-Sook;Lee, Ju-Im;Kim, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1193-1201
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    • 2007
  • Purpose: This study was aimed to identify the factors that influence eating behaviors in coronary artery disease patients and to create data for nursing which is thought to improve the eating behavior. Method: The study population was coronary artery disease patients who were treated on an outpatient basis. The measurements were eating behavior, diet self-efficacy, perceived-benefits, perceived-seriousness, family support and medical team support. All of the measurement tools above were thoroughly modified to verify validity and reliability. Statistical analysis was done by the SPSS PC 12.0 program. Results: The influencing factors for the eating behavior was diet self-efficacy (${\beta}=0.476$), social support (${\beta}=0.253$), chest pain (${\beta}=0.177$), smoking (${\beta}=-0.173$) and regular exercise (${\beta}=.169$), which explained 46.2%. Conclusion: Eating behaviors of coronary artery disease patients were influenced by diet self-efficacy, family support and the presence of chest pain. Therefore, the development of a program for efficient dietary education that prevents the progression of coronary artery disease is needed.

Effects of Self-Checked Monitoring Home Exercises on Gait, Balance, Strength, and Activities of Daily Living in People with Parkinson's Disease

  • Lim, Chaegil
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.1
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    • pp.1940-1949
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    • 2020
  • Background: Self-checked monitoring home exercises are recommended for preventing falls among people with Parkinson's disease. However, as these home exercises are performed autonomously by patients without professional management, their accuracy and efficiency can be compromised. Objective: To investigate the effects of providing regular training sessions to patients and caregivers and of patient self-monitoring of exercise performance following the implementation of a self-checked monitoring exercise program for people with Parkinson's disease. Design: Randomized Pretest-Posttest Control Group Design. Methods: We provided regular self-checked monitoring home exercise and general home exercise programs to 30 participants for 12 weeks. Once a month at the first, fifth, and ninth-week sessions, a rehabilitation team attended the Parkinson's group education. In addition to the subject in the experimental group perform the home exercises program to provide feedback regarding the home exercises program and to carry out a self-monitoring checklist performance for 12 weeks. Results: The 10 m walk test, functional reach test, and sit to stand test and the modified Barthel index significantly improved in the self-checked monitoring home exercise group. Conclusion: These results suggest that self-checked home exercise programs, which facilitate safety and consistent performance of exercises at home, are beneficial for people with Parkinson's disease.

Factors associated with the prescription of probiotics in patients with inflammatory bowel disease: a cross-sectional study

  • Joo Kyung Kim;Jae Hee Cheon
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.37-48
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    • 2023
  • Background: Commensal bacteria play an important role in the pathogenesis of inflammatory bowel disease (IBD) and probiotics have been used as treatment options. We aimed to explore the current use of probiotics and factors associated with their prescription in patients with IBD. Methods: This cross-sectional study was conducted on a single hospital-based cohort. Patients were eligible if they were ≥18 years old, visited the IBD clinic as an outpatient more than twice during the study period, and had a confirmed diagnosis of IBD. Patients were divided into two groups based on the prescription of probiotics. Clinical assessments were compared between the two groups. Results: In total, 217 patients were enrolled in this study. In patients with Crohn disease (CD), moderate or severe abdominal pain; prior use of methotrexate (MTX), iron, thiopurines, or biologics; history of IBD-related surgery; and stool frequency were independently associated with the prescription of probiotics. In patients with ulcerative colitis (UC), moderate or severe abdominal pain, hematochezia, stool frequency, and moderate or severe physician global assessment score were independently associated with the prescription of probiotics. Conclusion: Increased disease activity may be associated with fewer prescriptions of probiotics in patients with IBD. However, physicians prescribed probiotics to control symptoms, such as abdominal pain and increased stool frequency in patients with UC and CD, and hematochezia in patients with UC. Additionally, the use of MTX and iron, and a history of IBD-related surgeries were associated with more frequent probiotic prescriptions in patients with CD.

The study for recent changes of disease-mix in health insurance data (의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -)

  • Yu, Seung-Hum;Jung, Sang-Hyuk
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.345-357
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    • 1990
  • Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

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Analysis of the Health Expenditure and Medical Usage Difference of the Baby Boomers between Male and Female: Depression as a Mediators (베이비붐세대의 남녀 간 의료비 지출 및 의료이용 차이: 우울을 매개변수로)

  • Jeong, Ji Yun;Jeong, Jae Yeon;Cha, Sun Jung;Lee, Hae Jong
    • Health Policy and Management
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    • v.29 no.2
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    • pp.160-171
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    • 2019
  • Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

Effects of the COVID-19 Pandemic on Cardiac Surgery Practice and Outcomes

  • Gopal, Kirun;Krishna, Neethu;Jose, Rajesh;Biju, Surya Sree Chitra;Pichandi, Jaya Suriya;Varma, Praveen Kerala
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.61-68
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    • 2022
  • Background: While the coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of health care, its impact on cardiac surgical practice and outcomes is yet to be determined. We compared the outcomes of our cardiac surgical practice from the past year during the pandemic to those in a similar pre-pandemic period. Methods: Retrospective data were collected from 307 patients who were involved in all adult cardiac surgical procedures performed between March 2020 and February 2021, which was considered the pandemic period, at Amrita Institute of Medical Sciences, India. These were compared with data from the 1-year period between March 2019 and February 2020. During that earlier period, 491 patients underwent surgery, and the surgical outcomes were assessed. Outpatient visit data were also collected to evaluate the effect of COVID-19 on outpatient follow-up visits. Results: A 37% decrease in surgical case volume was observed during the study period. No difference was found in operative mortality between the 2 time periods (3.3% vs. 2.6%, p=0.383). Overall postoperative complications were less frequent during this period, at 23% compared to 38% the previous year (p<0.001). Conclusion: The COVID-19 pandemic caused a dramatic decrease in surgical volume and outpatient medical follow-up. However, the pandemic and its attendant social restrictions did not yield a significant change in the surgical outcomes of our patients. Hence, it is reasonable to continue cardiac surgical care during global health crises, and this can be done with good results.

Factors Associated with Health Service Utilization of the Disabled Elderly in Korea (장애노인의 의료이용에 영향을 미치는 요인)

  • Jeon, Boyoung;Kwon, Soonman;Lee, Hyejae;Kim, Hongsoo
    • 한국노년학
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    • v.31 no.1
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    • pp.171-188
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    • 2011
  • The purpose of this study is to examine the factors associated with the probability and levels of the health service utilization among the disabled elderly in Korea. The sample includes 2,111 people older than 65 who are extracted from the 2008 National Survey on People with Disabilities. More than half (54.3%) of the sample experienced at least 1 outpatient physician visit within two weeks and 26.7% were hospitalized within a year. The key factors associated with the outpatient visits were health insurance status, the existence of chronic disease, self-rated health, the Activities of Daily Living (ADLs), as well as renal impairment. Similarly, the utilization of inpatient care was related to health insurance status along with the existence of the internal organ disabilities such as cardiac or respiratory disorders. The study implies the need for the health care policies regarding the prevention of chronic diseases, dependency for daily activities of the elderly, and a management system that specifically targets those with internal organ disabilities. Moreover, the study suggests that financial supports for the low-income group would be helpful to increase their access to health service utilization.