• 한국노년학
• /
• v.29 no.2
• /
• pp.629-643
• /
• 2009

The purpose of this study is, by using the demographic variables, to identify self-efficacy, social support, and quality of life of the elderly with depression and to assess the impacts of these factors upon their quality of life. By analyzing the factors which have an impact upon the life quality of the elderly with depression, this study aims to provide important information which help understand them, and to find out what kind of care is necessary for their happy and satisfactory life. The study took purposive sampling and survey of 215 people among the elderly with depression who were under care of the outpatient clinics, day hospitals, and mental health clinics located in Seoul and Kyunggi Province, Korea. This study was conducted from November 10th to 20th, 2008 and the data were collected using the questionnaires of self-efficacy, social support, and quality of life scales. Using a SPSS/WIN 15.0 program, the analysis of the data showed the following results. First, among the demographic characteristics, the elderly with depression who were male, had spouse, higher education, no public assistance, shorter period of depression, and were healthy turned out to have higher self-efficacy. In terms of social support, the participants who had higher education, no public assistance, and were healthy turned out to have more social support. Further, in terms of quality of life, the variables of spouse, public assistance, period of depression, and health condition were statistically significant. Second, as a result of hierarchical regression, it appeared that the elderly with depression, who had higher self-efficacy, more social support, spouse, good health, no public assistance, and shorter period of depression, turned out to have higher quality of life. Based on the study findings, the implications of social work practice, policy, and future research were discussed.

• Clinical and Experimental Pediatrics
• /
• v.45 no.4
• /
• pp.489-497
• /
• 2002

Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.3
• /
• pp.320-329
• /
• 2003

Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

• Journal of muscle and joint health
• /
• v.8 no.1
• /
• pp.122-140
• /
• 2001

The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.2
• /
• pp.179-186
• /
• 2008

Purpose: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. Methods: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. Results: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. Conclusion: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.

• Child Health Nursing Research
• /
• v.7 no.3
• /
• pp.322-341
• /
• 2001

The family value is expected to play a crucial role in adjusting a new environment for the family, especially in the critical situation as having a child with cancer in the family. The purpose of the study was to analyze the family values of the family with cancer children in order to offer descriptive data, which will facilitate family adjustment with cancer children. The survey was conducted from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of the children who have been diagnosed as cancer, 18 years of age or less, and treated either hospitalized or at the outpatient clinics. Two instruments were used to measure family value. The modified form of General family value scale was 18 items with a 5 points of Likert response format (Cronbach alpha= .78) and Family value scale was developed for the study with 12 items on a 5 points of Likert response format(Cronbach alpha= .73). The data analysis utilized SAS 6.12 for percentage, frequency, Mean, and t-test of demographic characteristics and mean, F score, ANOVA, and Duncan follow-up test of variable relationships. The study findings were as follows. 1) In General family value, the fathers gave the higher scores to 'The children should live with their parents'(M=4.01), and 'A parents and their children are like one body' (M=3.91). The item with lowest score was 'Its not impossible for man to have extramarital relationship'(M=1.92). The mothers thought the most important items were 'A parents and their children are like one body'(M=3.79), and 'A wife needs to be patient to keep harmony of the family' (M=3.56), and the item with lowest score was 'Its not impossible for man to have extramarital relationship'(M=1.44). 2) The mean scores of the mothers were higher than the fathers for all items in family value with cancer children, while fathers gave more points for items in general family value. Both of parents gave the highest score to 'The health of the family is most important to me'(M=4.85 for fathers, M=4.97 for mothers), and followed by 'The husband and wife need to be patient and understand each other to overcome the difficulties'. The item with lowest scores was 'The parents can have conflicts in making decisions since their child was sick'(M=3.34 for fathers, M=3.37 for mothers). 3) There were significant differences between fathers and mothers in items of General family value; fathers gave more points to the items of 'The children should live with their parents', 'Its essential to hold the ceremony to respect their forefathers', 'Its not impossible for man to have extramarital relationship', 'A woman with two daughters should have one more baby to succeed the generation', 'The husbands are responsible for the household economy', and 'When his mother and wife dont get along, the man should be on his mothers side'. However, there was no significant difference between fathers and mothers in items of Family value with cancer children. 4) The general family value was significantly different by the birth order of cancer children, mothers age, mothers education level, and types of payment. On the other hand, the family value with cancer children was significantly different by the age of cancer children, period of illness, period after completing treatment, family type, the number of family members, and the number of total children.

• Journal of Preventive Medicine and Public Health
• /
• v.26 no.3 s.43
• /
• pp.457-468
• /
• 1993

This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.1%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow : the routine CBC was 75.0%, the liver function test was 72.1%, and the computer tomogram was 15.4%.

• Journal of Korean Academy of Nursing
• /
• v.29 no.1
• /
• pp.161-173
• /
• 1999

The purpose of this study was to develope and test the structural model for quality of life in women having hysterectomies. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around eight constructs. Exogenous variables included in this model were marital intimacy, importance of uterus, professional support, positive coping behavior and pre-operative symptoms. Endogenous variables were spouse's support, sense of loss and quality of life. Empirical data for testing the hypothetical model was collected using a self-report questionnare from 203 women having hysterectomies at the outpatient clinics of four general hospitals and a mail survey in Pusan City. The Data was collected from December, 1997 to January, 1998. Reliability of the eight instruments was tested with Cronbach's alpha which ranged from 0.639-0.915. For the data analysis, SPSS 7.5 WIN Program and LISREL 8.12 WIN Program were used for descriptive statistics and covariance structural analysis. The results of covariance structure analysis were as follows : 1. Hypothetical model showed a good fit with the empirical data. ［$\chi$$^2$＝6.93(df＝5, P＝.23), GFI＝.99, AGFI＝.94, RMSR＝.019, NNFI＝.97, NFI＝.98, CN＝440, standardized residuals(-2.14-2.10)］ 2. For the parsimony of model, a modified model was constructed by deleting 3 paths and adding 1 path according to the criteria of statistical significance and meaning. 3. The modified model also showed a good fit with the data. ［$\chi$$^2$＝5.26(df＝7, P＝.63), GFI＝.99, AGFI＝.97, RMSR＝.014, NNFI＝1.02, NFI＝.99, CN＝710, standardized residuals(-1.46-1.70)］ Results of the testing of the hypothesis were as follows : 1. Marital intimacy(${\gamma}$11＝.78, t＝14.37) and professional support(${\gamma}$13＝.12, t＝2.12) had a significant direct effect on the spouse's support. 2. Pre-operative symptoms(${\gamma}$25＝.32, t＝3.12), importance of uterus(${\gamma}$22＝.20, t＝2.61) and spouse's support($\beta$2l＝-.19, t＝-2.43) had a significant direct effect on the sense of loss. 3. Sense of loss($\beta$32＝-.66, t＝-9.83) had a direct effect on the quality of life. Marital intimacy had a direct(${\gamma}$31＝.19, t＝3.33), indirect(${\gamma}$31＝.14, t＝2.52) and total effect(${\gamma}$31＝.25, t＝4.41) on the quality of life. Professional support had a direct effect(${\gamma}$33＝.11, t＝2.07) and total effect(${\gamma}$33＝.13, t＝2.31) on the quality of life. The direct effect of pre-operative symptoms(${\gamma}$35＝-.36, t＝4.02) and positive coping behavior(${\gamma}$34＝.15, t＝2.06) had the insignificant effect on the quality of life while, due to the idirect effect these variables had overall significant effect on the quality of life. The results of this study showed that the sense of loss had the most significant direct effect on the quality of life. Marital intimacy, pre -operative symptoms and spouse's support had a significant direct effect on this sense of loss. These four variables, the sense of loss, marital intimacy, pre-operative symptoms and spouse's support, were identified as relatively important variables. The results of this study suggested that there is needed to determine if nursing intervention would alleviate this sense of loss and promote a greater quality of life in women who have had hysterectomies.

• Korea Journal of Hospital Management
• /
• v.22 no.3
• /
• pp.1-17
• /
• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.