• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.196-204
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• 2003

Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

• Investigative Magnetic Resonance Imaging
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• v.17 no.4
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• pp.275-285
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• 2013

Purpose : The objective of this study was to investigate effects of different smoothing kernel sizes on brain tissue-masked susceptibility-weighted images (SWI) obtained from normal elderly subjects using voxel-based analyses. Materials and Methods: Twenty healthy human volunteers (mean $age{\pm}SD$ = $67.8{\pm}6.09$ years, 14 females and 6 males) were studied after informed consent. A fully first-order flow-compensated three-dimensional (3D) gradient-echo sequence ran to obtain axial magnitude and phase images to generate SWI data. In addition, sagittal 3D T1-weighted images were acquired with the magnetization-prepared rapid acquisition of gradient-echo sequence for brain tissue segmentation and imaging registration. Both paramagnetically (PSWI) and diamagnetically (NSWI) phase-masked SWI data were obtained with masking out non-brain tissues. Finally, both tissue-masked PSWI and NSWI data were smoothed using different smoothing kernel sizes that were isotropic 0, 2, 4, and 8 mm Gaussian kernels. The voxel-based comparisons were performed using a paired t-test between PSWI and NSWI for each smoothing kernel size. Results: The significance of comparisons increased with increasing smoothing kernel sizes. Signals from NSWI were greater than those from PSWI. The smoothing kernel size of four was optimal to use voxel-based comparisons. The bilaterally different areas were found on multiple brain regions. Conclusion: The paramagnetic (positive) phase mask led to reduce signals from high susceptibility areas. To minimize partial volume effects and contributions of large vessels, the voxel-based analysis on SWI with masked non-brain components should be utilized.

• Korean Journal of Acupuncture
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• v.29 no.2
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• pp.188-199
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• 2012

Objectives : This study was performed to find the desirable remaining time of needle in the acupuncture treatment. Methods : The 21 volunteers were given acupuncture at LU9 vertically and needles were remained for 2 min, 10 min, 15 min, 30 min, respectively. The thermographic change induced by acupuncture was measured with Digital Infrared Thermographic Image at the following acupoints: LU11, LU10, LU9, LU8, LU5, LU1, and PC7. The statistical significance of thermographic change was evaluated using paired t-test and post hoc Wilcoxon test. Results : The most significant changes after acupuncture were produced when needles were remained for 10 min or 15 min. LU11, LU5, LU1, and PC7 were the point at which all of the remaining time produced significant change commonly. At LU11, the biggest change was produced when needle was remained for 15 min, while at LU5, LU1, and PC7, the biggest change was produced when needle was remained for 30 min, and the smallest change was produced when needle was remained for 10 min at all of acupoints of LU11, LU5, LU1, and PC7. The unbalance between left side and right was decreased the most largely in 15 min group. Conclusions : The results of this study suggest that the desirable remaining time of acupuncture needle might be 15 min.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.129-137
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• 2001

Objectives: The purpose of this study is to investigate the effects of 38-hour sleep deprivation on fine motor performance. The Motor Performance Series (MPS) in the Vienna Test System (computerized neurocognitive function tests) was used in this study. Methods: Twenty four subjects participated in this study. Subjects had no past history of psychiatric disorders and physical illness. Subjects had normal sleep-waking cycle without current sleep disturbances and were all right-handed (Annett's Hand Preference Questionnaire: above +9 points). To minimize the learning effects, familiarization with the Vienna Test System was performed one day before the study. Subjects were to get up at 6:00 in the morning after getting enough sleep according to his or her usual sleep-wake cycle. After awakening, subjects remained awake for 38 hours under continuous surveillance. During two consecutive study days, the subjects tested MPS at 7 AM and 7 PM each day, which means the MPS was done four times in total. During the experiment, anything that could affect the subjects' sleep such as coffee, tea, alcohol, a nap, tiring sports, and all medications were prohibited. Results: In MPS, the fine motor functions of both hands decreased after 38 hours of sleep deprivation. The decrement in motor performance was prominent in the dominant right hand. In the right hand, the total number of tapping was reduced (p<.005), and the number of misses (p<.05) and the length of misses (p<.05) of line tracking, the total length of inserting a short pin (p<.01), the total length of inserting a long pin (p<.05), and the number of misses in aiming (p<.05) increased. Such performance decrement was distinct in the morning sessions. Conclusions: These results suggest that fine motor performance decrement during sleep deprivation is predominant in the right hand, which exerts maximal motor function. The finding of decrement in motor function in tapping during sleep deprivation also suggested that the time required for exhaustion of muscles is shortened during sleep deprivation. More deterioration of motor performance was shown in the morning, which could be explained as circadian rhythm effects.

• Women's Health Nursing
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• v.7 no.2
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• pp.169-187
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• 2001

This study was performed to probe the effect of exercise program on muscle strength, endurance, flexibility, pain, disability level and life satisfaction in female teachers of elementary school who complain of low back pain. For this study, 44 female teachers aged 30-50 years with mechanical low back pain of 6 months' duration, who had the structural normalities in the lumbar spine, were recruited from April 1 to July 10 1999. Twenty three out of them were assigned to the experimental group and twenty one to the control group. The exercise program consisted of education on right postures, the etiology and diagnosis of low back pain, and exercise intervention such as muscle relaxation, elongation and strengthening. With 8 weeks program, the subjects received two sessions of education and six sessions of group exercise in the 1st week, while three sessions of group exercise and four sessions of individual exercise weekly and two sessions of education during the later 7 weeks. The muscle strength and endurance were measured by Cybex 770, the flexibility by flexibility measurement machine, the intensity of pain by Visual Analogue Scale (VAS), the level of disability by Oswestry low back pain disability scale, depression by Beck depression inventory (BDI), and life satisfaction by Life satisfaction index-Z. Study measurements were taken before and after 8 weeks exercise program. Data were analyzed using paired t-test, t-test, and ANCOVA. The results were as follows ; 1. The flexors and extensors peak torque and flexors peak torque per body weight of experimental group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of control group. There was no significant difference in extensors peak torque per flexors peak torque at $30^{\circ}/sec$, $60^{\circ}/sec$ between experimental and control group. 2. The flexors and extensors total work and flexors total work per body weight of experimental group were significantly increased at $120^{\circ}/sec$, compared with those of control group. 3.The flexibility of lumbar spine in experimental group was significantly increased compared with that of control group. The pains in anterior, posterior, left lateral and right lateral bending and in rotation of experimental group were significantly increased compared with those of control group. 4. The Oswestry disability scores of experimental and control group were significantly decreased, and there was no difference in the Oswestry disability score change between experimental and control group. 5. The scores of BDI of experimental group were significantly decreased compared with those of control group. Life satisfaction index-Z scores of experimental group were not changed, but those of control group were significantly decreased. There was no difference in the score change of Life satisfaction index-Z between experimental and control group. 6. ANCOVA analysis for the data variables of inhomogeneous baseline represented that there was no significant difference in extensors peak torque and extensors total work at $120^{\circ}/sec$ and extensor total work per body weight at $120^{\circ}/sec$ change between experimental group and control group. These findings indicate that the exercise program could be effective in increasing the muscle strength, endurance, flexibility and decreasing pain, improving depression in female teachers of elementary school with chronic low back pain. It is suggested that the exercise program could be an essential factor for the effective nursing intervention to the patients suffered from chronic low back pain.

• Journal of dental hygiene science
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• v.9 no.3
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• pp.327-338
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• 2009

This study was to develop an instrument for multidimensional measurement of Korean scaling fear (KSF)-1.0 and analyze related factors. A sample of 720 subjects(scaling patients and community people) was studied in Daegu city from November in 2008 to March in 2009. Authors first conceptualized the KSF, item generation, item reduction, and questionnaire formatting were performed in the stage of the development. Item descriptive, missing%, item internal consistency, and item discriminant validity were analyzed in the item-level, also descriptive, floor and ceiling effect were analyzed in the scale-level. Cronbach's alpha, test-retest, inter-dimension correlations, and factor analysis were performed to evaluate the validity and reliability in the new instrument. Confirmative factor analysis was did to evaluate the fit of model. The results for item-level and scale-level were acceptable except item discriminant validity. The reliability for 0.92~0.96 of corelation coefficient range(Cronbach's alpha 0.96~0.98) was high in the test-retest, and there was no significant difference in paired t-test. Item internal consistency(range of pearson corelation coefficient 0.39~0.95) was also high. The result of explanatory factor analysis was the same as the intended dimension structure, also confirmatory factor analysis results revealed that the dimensional structure model were fined well in the evaluation of model fit($x^2$= 1245.66, df=146, p=0.0000; GFI=0.85; AGFI=0.80; RMSEA=0.10). Factors related to KSF by multiple regression were gender($\beta$=0.28, p=0.0004) and teeth brush method($\beta$=-0.15, p=0.0053) in scaling patients, also gender($\beta$=0.25, p=0.0002), educational level($\beta$=0.14, p=0.0155), teeth brush method($\beta$=-0.09, p=0.0229) and time of daily work out($\beta$=-0.10, p=0.0055) were significantly associated with KSF in no scaling group. In conclusion, The results of this study reveal that the new developed measurement scale was reliable and val id instrument for measuring the KSF in dental hygiene patients and community people. We recommend that further research should develop more the instrument for the Korean scaling fear.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.2
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• pp.94-101
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• 2006

Objectives : A variety of symptoms are typically reported during anxiety period, several of which are clearly linked to the autonomic nervous system(ANS), such as palpitations, chest pain and shortness of breath. Using spectral analysis of heart rate, several studies have shown that patients with anxiety disorder are characterized by a reduced heart rate variability(HRV), indicative of abnormalities in ANS fuction. To further evaluate the effect of anxiety and medication on autonomic function, 30 patients and 30 matched control subjects were assessed. Methods : Using spectral analysis of heart rate, which consisted of standardised measurements of HRV, we compared ANS between 30 patients with DSM-IV diagnosed anxiety disorder and 30 healthy controls, and investigated the autonomic effects of SSRI treatment. Five-minute HRV recordings were obtained before and after SSRI treatment and were analysed. Results : Five-minute HRV recordings in anxiety disorder patients revealed that a significant reduction in HRV was shown compared to controls. There was no significant changes in HRV between before and after SSRI treatment. Conclusion: Anxiety disorder patients showed a significant reduction in HRV compared to controls. SSRIs do not affect HRV influenced by ANS function. Further study is needed to confirm these things. Patients with anxiety disorder may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic tree.

• Journal of the Korean Society of School Health
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• v.12 no.2
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• pp.295-303
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• 1999

The purpose of this study was to evaluate the effect of systemic oral health education on the improvement of knowledge levels and patient hygiene performance(PHP) for elementary school students. The randomly selected 1st and 5th grade students in a public elementary school of Taegu city were divided by education group(118 students) and non-education group(122 students). The oral health education lesson was systematically held on the education group once a month for 4 months. The questionnaire queried all the subjects about their knowledge and attitudes before and after oral health education, and PHP was also tested at the same time. Corresponding p-values were significantly considered at values less than 0.05. The obtained results were as follows: Due to the oral health education lesson, the education group of both 1st and 5th grade students came to have a higher knowledge level than the non-education group. There was high improvement of items such as toothbrushing time, toothbrushing method, cause of dental caries, treatment after tooth damage, and tongue-brushing. Therefore, these items should be educated to all the elementary school students. By increaseing the knowledge level of oral health after education, the PHP index in the education group was significantly decreased in comparison to the non-education group and hence the capability of oral health management improved. From the above results, a systematically and periodically oral health education system for elementary school students can improve the knowledge level and capability of oral health management. Further study will be required to develop an easy and acceptable systemic oral health education program for elementary schools.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.18-32
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• 1994

It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2％). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.