• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.400-414
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• 1999

Objectives: This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. Methods : Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. Results : Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of Hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. Conclusions: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.943-952
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• 1997

This study was done to analyze the effects of prompted voiding therapy on urinary incontinence in elderly patients in an elderly care hospital. Specifically, this study looks to evaluate the effects of prompted voiding as an intervention for improving independent voiding and also identified the relationship of urinary continence to cognitive, emotional, and physical factors. The study was based on a pre-experimental design used to evaluate the effects of prompted voiding therapy on an experimental group without a control group. An experimental group of 143 patients was selected through convenience sampling from patients in an elderly care hospital. The data was collected from November 4 to December 14, 1996. Prompted voiding therapy is a behavioral therapy for managing incontinence and it is applied to patients who are cognitively impaired and dependent. In this study, the patients were asked at each designated time whether or not they had to urinate. If they answered yes, they were either given a bedpan or were assisted to the bathroom, and if the patient answered no, their diaper was checked to determine whether or not it was wet. The results were then recorded on the patients urinary voiding record. The urinary voiding score based on the model presented by Burton(1984), Burke and Walsh(1992), Chenitz, Stone & Salisbury(1991) was modified and used as a tool in this study. After forty six out of the total of 143 patients were selected for interviews through random sampling the levels of cognitive functions, mental depression and ADL(activities of dally life) within the given time frame were measured. In this study, the cognitive function was measured using the scale developed by Kabhn, Goldfarb, Pollack & Peck(1960), elderly mental depression, using the tool developed by Sheikh & Yesavage(1986), and the ADL(activities of dally living), through the Barthel Index. The data was analyzed through SPSS windows for descriptive statistics, repeated measured ANOVA and Pearson's correlation. According to the results of the study, the application of the prompted voiding therapy can improve the voiding pattern of patients. It was shown especially that incontinence could be controlled by the intervention developed according to the individual voiding pattern. In terms of the relationship between cognitive function, mental depression and ADL and the voiding function score, a close correlation was not found. It was shown that urinary incontinence can be improved through therapy even though patients have problems nth their cognitive, mental and physical functions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.260-264
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• 2010

Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

• Korean Medical Education Review
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• v.16 no.2
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• pp.67-76
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• 2014

Few studies have examined burnout among the faculty of medical schools in the Republic of Korea. The aim of this study was to determine the level of burnout and its associated factors among the faculty members of three medical schools in the Busan-Gyeongnam area, and to summarise the available literature on burnout. We conducted the survey using a validated questionnaire that incorporated the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as well as questions about demographic characteristics, working experience, health, lifestyle, most time spent and most difficult work, and suicidal ideation and job quitting ideation of the survey participants. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (De), and personal accomplishment (PA). Through the survey, the 186 professors, 49% among the total, provided data which were included in the present analysis. More than thirty per cent (37.1%) of the professors reported at least 1 symptom of burnout. For burnout dimensions, 11.8% of the respondents scored high for EE burnout, 25.3% for De, and 14.5% for PA, with 1.6% scoring high on all three dimensions of burnout. High burnout was found to be strongly associated with several of the variables under study, especially hours worked per week, self-rated health, career (range, 4 to 9 years), and age (range, 50 to 59 years). The EE score was highest for the professors who chose 'patient care' as the most difficult type of work. This study showed that just over one-third of professors have at least 1 symptom of burnout and working more hours per week, short length of work (years), and especially suicidal ideation seem to be associated with the burnout of medical school faculty members in the Busan-Gyeongnam area. In summary, a greater risk of burnout of physicians (including medical professors) seems to be associated with specialties at the front line of care, working more hours per week, work-life imbalance, low self-efficacy, depression, and conflicts with colleagues and patients.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.220-227
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• 2009

Purpose: The purpose of the study was to investigate how much understand about artificial hydration in patients with terminal cancer, according to the subject groups, including patients, families, and general public. Methods: Data were collected from June 2007 to December 2007 and the participants included 22 hospitalized patients in the hospice unit of S Hospital, 100 families, and 101 participants who participated in a hospice education program for the general public. The questionnaire was developed through literature review, interview with patients' families, and expertise consultation. Data were analyzed using descriptive statistics with an SAS program. Results: Understanding of artificial hydration among patients, families and general public was examined from three perspectives. From an ethical perspective, 'if you receive artificial hydration, you can live longer', 45.5%, 63%, and 52.4% of the above three groups, respectively, answered "yes". From an emotional perspective, 'artificial hydration must be provided', 81.8%, 70% and 58.4%, respectively, agreed. From a cultural perspective, 'if artificial hydration is not provided for the patient, the families will feel painful', 95.5%, 83%, and 88.2%, respectively, answered "yes". Conclusion: This study found the differences in understanding of artificial hydration among patients, families and general public, and also found that less than 50 percent of the participants understood artificial hydration appropriately. We suggest, therefore, that patients' understanding about artificial hydration should be determined in the clinical setting and then followed by individualized education according to given medical situations.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.2
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• pp.226-239
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• 2006

Background : Medical records are documents in files which consist of all diagnostic studies and medical treatments patients had received while they were hospitalized or treated as outpatients. A doctor or medical team can use medical records as a data for diagnosis, treatment, and education. In traditional eastern asian medicine, medical reports have different forms and contents. The most important thing in medical reports of traditional eastern asian medicine was how to express practitioner's medical ideas. So it has a weak point, for example, it has poor information about patient and clinical process, which make some trouble to understand it. Methods and Results : We studied medical records in Gyojubuin-yangbang, a commentary book of Chen-zi-ming's Obstetrics and Gynecology textbook done by Xue-ji in Ming dynasty, China. This book consists of 10 parts; treatment of menstruation disorders and leukorrhea, general gynecology, treatment of infertility, education for fetus, diagnosis of fetus and gravida, treatment of general and obstetrical disease in gravida, care for delivery, postpartum care and treatment, and treatment of mass and inflammation. It has 546 medical records about women's disease that commonly believed as Xue-ji's case reports. They are all review articles and made during about 23 years from A.D 1523 to 1546. Most patients of Xue-ji's case reports were common people, this fact is different from that of case reports in Chen-zi-ming's Obstetrics and Gynecology textbook. Conclusion : Xue-ji was a very famous Ob&Gy doctor who was from Suzhou Jingsu province in China. He was born in A.D 1468, died in A.D 1588. He emphasize emotional factors in pathology and to tonify spleen and kidney. We think Xue-ji's medical records are good references for us to treat psychosomatic Ob&Gy disease and chronic women's disease.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.773-785
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• 1998

This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale (QLS), which was composed of six factors, developed by Ro, You Ja. The analysis was done using t-test, ANOVA Scheff test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in both groups, but economic life showed the lowest score in the families of hospital hospice patients, and emotional state showed the lowest score in those of home-based hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients (t=2.69, P= 0.008 ; 1=2.04, p=0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age(F=2.52, p =0.029), marital status (F=3.57, P=0.018), economic state(F=6.07, P=0.004), and education level(F=3.77, P=0.014). In the families of home-based hospice patients, QL had significant relationship with marital status (F=2.53, P=0.049), education level(F=4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020) 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis. In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These findings should be considered in nursing practice.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.78-87
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• 2008

Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.165-177
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• 2008

Objectives : Headache is one of the most common symptom in primary medical care. The purpose of this research is to examine persisting effects of acupuncture treatment for CTTH. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture method for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of CTTH was measured by VAS, and Headache Disability Inventory(HDI), Six point Likert Scale, Algometer score(Rt, Lt) before and after treatments. Results : 32 subjects finished study. There were no difference between two group on age, sex, weight, height, blood pressure, pulse, respiratory rate, differentiation of symptoms, surmise of treatment. In change of VAS, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of HDI(Total score, Emotional score, Functional score) and Six point Likert scale, after treatment decreased than before treatment in two group, but there were no statistical significance compared with two group and time. In change of two sides Algometer score, after treatment increased than before treatment in two group, and Lt algometer score was statistical significance compared with two group(p<0.001). And both sides Algometer score, threr were statistical significance compared with time. Conclusions : Acupuncture treatment has persisting effects that improve the symptoms and decrease the temporal muscle tenderness in patient with chronic tension-type headache.