• Title/Summary/Keyword: Patient Compliance

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Uncertainty, Anxiety and Coping with Mastectomy for Breast Cancer (유방절제술 환자의 불확실성, 불안 및 대처방식)

  • Cho, Ok-Hee
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1006-1017
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    • 2000
  • The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

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Factors associated with the survival rate and the marginal bone loss of dental implant over 7-years loading (7년 이상 기능한 임플란트의 변연골 흡수와 생존율에 영향을 주는 요인)

  • Choi, Jung-Hyeok;Koh, Jae-kwon;Kwon, Eun-Young;Joo, Ji-Young;Lee, Ju-Youn;Kim, Hyun-Joo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.2
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    • pp.116-126
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    • 2018
  • Purpose: The purpose of this study was to analyze the factors affecting the survival rate and the marginal bone level of dental implants that have functioned over 7-years. Materials and Methods: In 92 patients, 178 dental implants were included. Implant-related factors (diameter, length, prosthetic splint), patient-related factors (gender, smoking, plaque index, compliance to supportive periodontal therapy) and surgery-related factors (proficiency of surgeon, bone graft) were evaluated via clinical and radiographic examination. The marginal bone level was determined by intraoral standard radiography at the mesial and distal aspects of each implant using an image analysis software program. Results: The survival rate of all the implants was 94.94% and the marginal bone level was $0.89{\pm}1.05mm$, these results are consistent with other studies that present long-term good clinical results. Implant length and plaque index among several factors were statistically significant for implant survival rate (P < 0.05). Smoking and the presence of regeneration surgery were statistically significant for the marginal bone level (P < 0.05). Conclusion: Dental implant that have functioned over 7-years showed favorable long-term survival rates and marginal bone level. Implant length and plaque control should be considered for improving the long-term clinical results. It is needed that careful application of bone regeneration technique and smoking control for maintaining of marginal bone level.

Radiation Therapy Combined with Cisplatin Based Chemotherapy for the Patients with Locally Advanced Nasopharyngeal Cancer (국소 진행된 비인강암의 방사선-항암제 병용요법)

  • Son, Seok-Hyun;Kim, Ji-Yoon;Kim, Sung-Whan;Mun, Seong-Kwon;Cho, Seung-Ho;Park, Young-Hak;Hong, Young-Seon;Kim, Yeon-Sil
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.123-129
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    • 2006
  • Objective : This retrospective study was designed to evaluate the anti-tumor efficacy and toxicities of the radiation therapy(RT) combined with cisplatin-based chemotherapy in locally advanced nasopharyngeal cancer(NPC). Materials and Methods : Fifty three patients with locally advanced NPCs(AJCC stage II, III, IV) received curative RT and cisplatin-based chemotherapy. Duration of follow-up ranged from 5.5 to 201 months(median 50.8 months). Nineteen patients(35.8%) were treated with induction chemotherapy including cisplatin $100mg/m^2$ for 1 day and 5-fluorouracil $1g/m^2$ for 5 days followed by RT(Induction CTx-RT). Another 34 patients (64.2%) were treated with concurrent chemoradiation(CCRT) using cisplatin $100mg/m^2$(D1, 22, 43). Results : Thirty-six(67.9%) and 11(20.8%) patients achieved clinical complete response and partial response, respectively. The pattern of failure was as follows:14 locoregional recurrence(26.4%) and 7 distant metastasis(13.2%). Among them, two patients(3.8%) had both locoregional and distant failure. Median overall survival(OS) and progression-free survival(PFS) were 85.5 months and 87.5 months, respectively. Five-year OS rate was 57.1%. The stage(AJCC), tumor response to chemoradiation and T stage were significant prognostic factors for OS(p=0.0113, p=0.0362 and p=0.0469). The stage(AJCC), tumor response to chemoradiation were also significant prognostic factors for PFS(p=0.0329, p=0.0424). Compared to each treatment group(Induction CTx-RT vs. CCRT), there were no significant differences in OS and PFS(p=0.7000, p=0.8261). Grade 3-4 mucositis, nausea/vomiting and hematological toxicities were noticed in 35.8%, 11.3% and 13.2%, respectively. Delayed RT over 2 weeks was inevitable in 26.5%. Seventeen patients(50%) successfully completed planned 3 courses of cisplatin in CCRT group. Conclusions : RT combined with cisplatin-based chemotherapy in locally advanced NPC showed high response rate, good locoregional control, and survival rate. As expected, frequency of acute toxicities increased, and the patient's compliance to treatment was need to be improved. Although our data could not show additional survival benefit of CCRT compare to that of induction chemotherapy followed by RT, patients' accrual and further follow-up are required due to limitation of retrospective study.

Characteristics of Pulmonary Tuberculosis in Elderly People (노인 폐결핵의 특징)

  • Shin, Ji-Young;Jung, Sun-Young;Lee, Jeong-Eun;Park, Ji-Won;Yoo, Su-Jin;Park, Hee-Sun;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.163-170
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    • 2010
  • Background: Pulmonary tuberculosis remains a health concern in Korea despite major progress in the development of new strategies for diagnosing and treating tuberculosis. In particular, the diagnosis of newly developed pulmonary tuberculosis is on the rise in elderly persons. The aim of this study was to investigate the clinical, radiographic characteristics, and treatment outcomes of pulmonary tuberculosis in the elderly. Methods: The medical records of 113 young (<65 years old) and 112 elderly (${\geq}65$ years old) pulmonary tuberculosis patients diagnosed at Chungnam National University hospital between January 2007 and December 2008 were reviewed. Results: There was no difference in the prevalence of typical symptoms between the younger and the elderly group. Dypsnea was the only symptom that occurred more frequently in the elderly group (16.8% vs 5.5%, p=0.008). On radiological study, pneumonic infiltration type was more common in the elderly group (28.6% vs 16.8%, p=0.035). Sputum Acid fast bacilli smear positivity rate was similar between the 2 groups. Elderly patients with anti-tuberculosis medication had more frequent adverse drug reactions; however, there was no significant difference between the 2 groups in the number of patients required to stop medication due to an adverse drug reaction. There were more patients lost to follow-up in the elderly group (22/112, 19.6% vs 11/113, 9.7%, p=0.036). Conclusion: The majority of elderly patients did not complete the treatment, resulting in a poorer outcome. Therefore, we need to make an effort to support the continued screening of elderly patients by making this economically feasible.

Gait Analysis After Posterior Cruciate Ligament Reconstruction Using Fresh-Frozen Achilles Allograft (신선 동결 아킬레스 동종건을 이용한 후방십자인대 재건술 후 보행분석)

  • Chun, Churl-Hong;Cho, Jae-Deuk;Chun, Keun-Churl
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.76-82
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    • 2009
  • Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.

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Colorectal Cancer Screening among Government Servants in Brunei Darussalam

  • Chong, Vui Heng;Bakar, Suriawati;Sia, Rusanah;Lee, James;Kassim, Norhayati;Rajak, Lubna;Abdullah, Muhd Syafiq;Chong, Chee Fui
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7657-7661
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    • 2013
  • Background: This study concerns uptake and results of colorectal cancer (CRC) screening of government servant as part of the Health Screening Program that was conducted in Brunei Darussalam in 2009. Materials and Methods: Government servants above the age of 40 or with family history of CRC were screened with a single fecal occult blood test (FIT, immunohistochemistry). Among 11,576 eligible subjects, 7,360 (66.9%) returned their specimen. Subjects with positive family history of CRC (n=329) or polyps (n=135) were advised to attend clinics to arrange screening. All the subjects with positive FIT (n=142, 1.9%) were referred to the endoscopy unit for counselling for screening colonoscopy. Results: Overall only 17.7% of eligible subjects attended for screening; 54.9% (n=79/142) of positive FIT, 8.8% (n=29/329) of positive family history of CRC and none with history of polyps (n=0/135). Of these, only 54 patients (50.5%) agreed for colonoscopy, 52 (48.6%) declined as they were asymptomatic, and one was not offered (0.9%) due to his very young age. On screening colonoscopy, 12.9% (n=7) had advanced lesions including a sigmoid carcinoma in situ and six advanced polyps. The other findings included non advanced polyps (n=21), diverticular (n=11) and hemorrhoids (n=26). One patient who missed his screening colonoscopy appointment re-presented two years later and was diagnosed with advanced right sided CRC. All the advanced lesions were detected in patients with positive FIT, giving a yield of 20.5% for advanced lesions including cancers in the 5.1% FIT positive subjects. Conclusions: Our study showed screening for CRC even with a single FIT was effective. However, the uptake rate was poor with just over half of the patients agreeing to screening colonoscopy. Measures to increase public awareness are important. Since one limitation of our study was the relatively small sample size, larger studies should be conduced in future.

Pharmacokinetic Evaluation and Gastric Ulcer Symptoms comparison of Ketorolac Tromethamine Sustained-Release Pellets after Oral Administration in Beagle Dogs (비글견을 이용한 케토롤락트로메타민 서방형 펠렛 제제의 위궤양 증상 비교와 약물속도론적 평가)

  • Yoon, Yang-No;Kim, Su-Ji;Jung, Suk-Hyun;Kim, Hyo-Jeong;Park, Eun-Seok;Hwang, Sung-Joo;Lee, Yong-Won;Seong, Ha-Soo;Shin, Byung-Cheol;Cho, Sun-Hang
    • Journal of Pharmaceutical Investigation
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    • v.39 no.6
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    • pp.401-409
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    • 2009
  • Ketrorolac tromethamine (KT), a nonsteroidal anti-inflammatory drug (NSAID) is required repeated administration due to its short blood half-life. To avoid dose-dependent side effects of KT, sustained-release pellets containing KT were prepared by coating with Eudragit$^{(R)}$ RS 100 and Eudragit$^{(R)}$ NE 30D. The in vitro and in vivo drug release behavior of KT from Eudragit$^{(R)}$ RS 100 and NE 30D coated pellet (SR-A), Eudragit$^{(R)}$ RS 100 coated pellet (SR-B) and conventional commercial immediate-release tablet (IR) was investigated. KT from SR-A and SR-B was slowly released over several hours, whereas IR showed rapid initial release in vitro. The pharmacokinetic study in vivo was performed by oral administration in beagle dogs. 5 mg IR was administered 3 times at intervals 5 hr. Five milligrams of IR was administered 3 times at intervals of 5 hr and 15 mg of SR-A and SR-B did once. After administering IR, KT concentration in blood showed high peak- trough fluctuation and stomach ulcer were discovered. On the other hand, SR-A and SR-B sustainedly released KT and reduced the occurrence of stomach ulcer. There sustained-release pellets will be effective system to minimize dosedependent of side effect and improve patient compliance.

Influencing Factors for Post-traumatic Growth in Patients with Breast Cancer (유방암 환자의 외상 후 성장 영향 요인)

  • Choi, Sung-Hee;Lee, Young-Whee
    • The Journal of the Korea Contents Association
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    • v.16 no.11
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    • pp.499-509
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    • 2016
  • This study was undertaken to investigate the factors that influence post-traumatic growth in patients with breast cancer. The study subjects were 100 outpatients with breast cancer who visited the outpatient clinic of a university hospital. The instruments used for this study were Korean Post-traumatic Inventory (K-PTGI), Modified Medical Outcomes Study Social Support Survey (mMOS-SS), Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B) and Cancer Coping Questionnaire (CCQ). The data were analyzed by t-test, ANOVA, Pearson-correlation coefficient, and stepwise multiple regression using SPSS/WIN 21.0. The mean score of post-traumatic growth was $3.4{\pm}0.9$ out of 5. Post traumatic growth had statistically significant correlation with social support, breast cancer self-management self-efficacy, and coping behavior. In stepwise multiple regression analysis, post-traumatic growth was significantly influenced by therapeutic compliance related self-efficacy and positive reframing coping behavior and it was account for 29% of the total variance. These results suggest that these influencing factors should be considered in developing the nursing intervention to improve the post-traumatic growth in patient with breast cancer.

A Trend in Acquired Drug Resistances of Tuberculosis Patients Registered in Health Centers from 1981 to 2004 (1981년부터 2004년까지 보건소 재치료 결핵 환자의 항결핵제 내성률 추이)

  • Chang, Chulhun L.;Lee, Eun Yup;Park, Soon Kew;Jeong, Seok Hoon;Park, Young Kil;Choi, Yong Woon;Kim, Hee Jin;Lew, Woo Jin;Bai, Gill-Han
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.619-624
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    • 2005
  • Background : The drug resistance rate in tuberculosis patients with history of chemotherapy is an important indicator of for evaluation of appropriateness of treatment regimens and compliance of patients. This study examined the long-term changes in the drug resistance rates among TB patients failed in treatment or reactivated. Methods : The results of drug susceptibility testing data from patients registered in health centers from 1981 to 2004 were analyzed. Results : The rate of resistance to isoniazid decreased from 90% to 20%, and the resistance to ethambutol decreased from 45% to 6%. The rate of resistance to rifampicin varied from 13% to 28% and the resistance to pyrazinamide was 5% to 10%. Multidrug resistance was about 2-3% lower than any rifampicin resistance rates. The second-line drug resistance was ranged from 1% to 3%. There was no difference between patients' genders. Patient numbers per 100,000 population increased with age. The regional distribution was even at 4-6 patients per 100,000 population, and drug resistance rates were significantly lower in big city areas than in small towns and rural areas. Conclusion : The rates of resistance of Mycobacterium tuberculosis isolated from TB patients with history of chemotherapy to isoniazid, rifampin, ethambutol, and isoniazid plus rifampin were significantly decreased during over two decades.

5 YEARS EVALUATION OF COMPOSITE RESIN RESTORATION ON PERMANENT FIRST MOLAR IN CHILDREN (어린이 제 1 대구치 복합 레진 수복물의 5년 후 임상평가)

  • Kim, In-Young;Kim, Jae-Moon;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.110-117
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    • 2008
  • Clinical performance of resin-based composite material depends on case selection and on the proficiency of the operator. Especially, composite resin restoration on permanent first molar in children have more limitations clinically than adult patients according to stage of tooth eruption and patient's compliance. This study was designed to evaluate the clinical performance of posterior composite resin restoration in children after 5 years. 35 teeth of 16 patients who were received composite resin restoration on permanent first molar in Department of Pediatric dentistry, Pusan National University Hospital between January 2001 and December 2001 were evaluated based on Modified USPHS criteria. From the finding in this study, following conclusions can be made. 1. 6 teeth(17%) of 35 teeth was replaced, so 5-years survival rate of posterior composite resin restoration is 82.9%. 2. As results of each evaluation criteria, on color match, anatomic form, surface roughness, sensitivity/ discomfort, ideal A grade score was 86.2%, 93.1%, 86.2%, 86.2%, clinically accepted B grade score was 13.8%, 0%, 13.8%, 10.3%. On marginal adaptation and marginal discoloration, A grade score was 13.8%, 44.8% and B grade score was 79.3%, 34.5% and secondary caries rate was 20.7%. 3. 69.1% of teeth (20 teeth) was clinically accepted on all evaluation criteria.

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