Jang, Sung Ho;Jung, Young Jae;Kim, Min Gyu;Kwon, Sung Joon
Journal of Gastric Cancer
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제18권1호
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pp.48-57
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2018
Purpose: Postoperative adjuvant chemotherapy is usually prescribed to improve the survival of patients with advanced gastric cancer who undergo curative surgery. This study was designed to determine the impact that the degree of compliance with chemotherapy has on the prognosis of patients with gastric cancer. Materials and Methods: Among 252 patients with stage III gastric cancer who underwent curative surgery between July 2004 and December 2014, 85 patients were postoperatively treated with S-1, the oral fluoropyrimidine derivative, 23 received no chemotherapy, and 144 received other regimens. Overall survival was compared between the complete compliance group (who received 8 cycles of S-1 chemotherapy, n=44) and the incomplete compliance group (who received less than 8 cycles of S-1 chemotherapy, n=41). Factors that influenced patient compliance with chemotherapy were also analyzed. Results: The overall 5-year survival rate was significantly different between the complete chemotherapy and incomplete chemotherapy groups (80.0% vs. 42.7%, P<0.001). Based on univariate and multivariate survival analyses of patients who received S-1 chemotherapy, the independent prognostic factors were tumor, node, and metastasis (TNM) stage (IIIa vs. IIIb vs. IIIc) and compliance with chemotherapy. TNM stage and age are significant factors that influence compliance with chemotherapy. Conclusions: TNM stage and compliance with chemotherapy are independent prognostic factors in patients with stage III gastric cancer who received postoperative chemotherapy. TNM stage and age are significant factors that influence patient compliance with chemotherapy.
Purpose: Compliance in kidney transplant recipients is critical for a positive prognosis. Especially compliance with medications after kidney transplantation is a major health care issue with implications for graft rejection and graft loss. But the definition of compliance in transplantation varies among centers. The purpose of this study was to clarify the concept of compliance in kidney transplant recipients. Methods: A literature search was conducted using RISS, MEDLINE, CINAHL. The concept analysis was guided by the methodology posited by Walker and Avant. Results: In this study, we found the attributes of the concept: 'compliance with immunosuppressive medication', 'compliance with follow-up', 'compliance with early detection of graft rejection and complication', and 'compliance with prevention of complication'. The antecedents of 'compliance in kidney transplant recipients' included 'having a kidney transplant surgery' and 'normal function of transplanted kidney'. The consequences of 'compliance in kidney transplant recipients' included 'affecting the function of the transplanted kidney' and 'affecting the health of kidney transplant recipients. Conclusion: This study may contribute to the development of tools for measuring compliance in kidney transplant recipients, as well as benefit nursing interventions research to increase compliance in kidney transplant recipients.
Purpose: This study was a randomized single-blind trial of whole versus split-dose PEG solutions for colonoscopy preparation to compare the patient compliance, quality of bowel cleansing, and endoscopist's satisfaction. Methods: The participants were recruited from outpatients who planned to receive colonoscopy of C hospital in Busan. Sixty participants were randomly assigned to receive either a spit-dose group(n=30) consuming $2{\ell}$ of PEG solution twice, or a whole-dose group(n=30), consuming $4{\ell}$ of PEG solution once. These participants completed the questionnaire to assess their compliance before colonoscopy. The quality of bowel cleansing was assessed using the Ottawa Scale with the endoscopist who was blinded to the type of preparation, and their satisfaction by using VAS. Results: The participants who did not completely consume $4{\ell}$ of PEG solution were less in split-dose than in whole-dose group (0% vs 13.3%). The split-dose group complained less about abdominal pain(t=2.644, p=0.009) and abdominal bloating(t=2.802, p=0.013) with a statistical significance. For the quality of bowel preparation, there were no significant differences in the bowel cleansing scores and the endoscopist's satisfaction between two groups. Conclusion: Colonic preparation with split-dose of PEG solution could be a more useful method for better patient compliance, with no significant impact on bowel cleansing quality.
Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.
In order to determine the effect of individual patient teaching through home visiting on compliance with sick role behavior and the blood sugar level in diabetic patients, to determine if the effectiveness of the education was still present four year later and to inquire as to the effective time for a repeat education program this study was done through two quasi-experimental researches. The subjects consisted of 52 diabetic patients. The results of the study may be summarized as follows ; 1. Hypothesis I, in which the compliance with sick role behavior, the knowledge on diabetes and the health belief of the experimental group who received a diabetic education program will be higher than those of the control group who didn't receive the diabetic education, was supported by both studies in 1984 and 1988, confirming the effect on diabetic patients of the individualized education through home visiting ; In the 1984 study : Compliance(t=-11.7, p<.001) Knowledge(t=-5.41, p<.001) Health belief(t=-4.74, p<.001) In the 1988 study : Compliance(t=-4.85, p<.001) Knowledge(t=-2.85, p<.01) Health Belief(t=-2.99, p<.005) 2. The Hypothesis II, the blood sugar level of the experimental group will be lower than that of the control, was rejected in both studies, 1984 and 1988. 3. The Hypothesis III, the compliance, knowledge and health belief of the expermental group who received the education program in 1984 will not last till 1988, was supported in part, in compliance and health belief, but not in knowledge. In conclusion those who received the education program twice with an interval of 2 weeks, 4 years ago still had knowledge of diabetes but compliance and health belief had disappeared.
Purpose: The purposes of this study were to identify knowledge, health belief and compliance in patients with hypertension and to identify the most important predictors for compliance of hypertensive patient. Method: The participants in this study were 117 patients who were receiving treatment for hypertension at E. university hospital or one of three local clinics in D-city. Data were collected using a knowledge measurement instrument, health belief scale, and an instrument on compliance. Collected data were analyzed using $X^2$ test, ANOVA, multiple linear regression with PASW statistics 18.0 program. Results: There were statistically significantly positive correlations between knowledge of hypertension and health belief, health belief and compliance. But there was no correlation between knowledge of hypertension and compliance. In the multiple regression analysis, perceived barriers, perceived severity, perceived benefits were significant predictors to explain compliance and accounted for 54.1% of the variance in compliance. Conclusion: The results of the study indicate that health belief and compliance are significantly strongly correlated. Thus it is suggested that nursing interventions to improve compliance should include nursing care plans to increase health belief, perceived severity, perceived benefit and to decrease perceived barrier.
Objective: Poor experience with Invisalign treatment affects patient compliance and, thus, treatment outcome. Knowing the potential discomfort level in advance can help orthodontists better prepare the patient to overcome the difficult stage. This study aimed to construct artificial neural networks (ANNs) to predict patient experience in the early stages of Invisalign treatment. Methods: In total, 196 patients were enrolled. Data collection included questionnaires on pain, anxiety, and quality of life (QoL). A four-layer fully connected multilayer perception with three backpropagations was constructed to predict patient experience of the treatment. The input data comprised 17 clinical features. The partial derivative method was used to calculate the relative contributions of each input in the ANNs. Results: The predictive success rates for pain, anxiety, and QoL were 87.7%, 93.4%, and 92.4%, respectively. ANNs for predicting pain, anxiety, and QoL yielded areas under the curve of 0.963, 0.992, and 0.982, respectively. The number of teeth with lingual attachments was the most important factor affecting the outcome of negative experience, followed by the number of lingual buttons and upper incisors with attachments. Conclusions: The constructed ANNs in this preliminary study show good accuracy in predicting patient experience (i.e., pain, anxiety, and QoL) of Invisalign treatment. Artificial intelligence system developed for predicting patient comfort has potential for clinical application to enhance patient compliance.
Recently, the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal and diabetic group vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy is statistically lower than the normal group(p<0.05). We suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.
The purpose of this study was to determine the effects of an rehabilitation educational program on anxiety, health compliance and quality of life of the patient with cardiac valve replacement. The 80 Subjects for the study were surveyed at the outpatient clinic in S medical center in Buchon City in Korea. Among them, 40 patients had been taught about the cardiac rehabilitation education program and 40 patients had not been taught while they were in the hospital. Those 2 groups of patients were surveyed with the instruments of Spilberger's anxiety scale, and the questionnaire of health compliance and quality of life. The data were analyzed by using $X^2$-test, t-test, Pearson's correlation. The results of this study were as follows: 1. Anxiety in educated group was significantly decreased (t=-2.60, p= .011) comparing to u n edu cat ed group. 2. The health compliance in educated group was significantly in creased (t=2.09, p= .040) comparing to uneducated group. 3. The quality of life of the two groups of pa tients was not different significantly (t=1.83, p= .072). 4. The correlation between anxiety and health compliance was significantly reversed (r=- .461, p= .000). The correlation between anxiety and quality of life was significantly reversed (r=- .654, p= .000). The relationship between health compliance and quality of life revealed significant (r=.438, p= .000). Considering above results, the cardiac rehabilitation educational program for the patients with the cardiac valve replacement was strongly recommended to be used.
Kim, Kwang Seog;Sim, Ho Seup;Shin, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
대한두개안면성형외과학회지
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제18권3호
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pp.179-185
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2017
Background: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. Methods: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. Results: Overall subjects' compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. Conclusion: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.
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