• Title/Summary/Keyword: Patient family

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Development of a Tool to Measure Suffering in Patients with Cancer (암환자의 고통 측정도구 개발에 관한 연구)

  • 강경아
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1365-1378
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    • 1999
  • This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

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Relationships among Body Image, Self-esteem and Health Promotion Behavior in Mastectomy Patients (유방절제술 환자의 신체상, 자아존중감과 건강증진행위의 관계)

  • Jeong, Kyeong-Sook;Park, Geum-Ja
    • Asian Oncology Nursing
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    • v.7 no.1
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    • pp.36-46
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    • 2007
  • Purpose: This study was designed to fine out the relationships among body image, self-esteem and health promotion behavior in mastectomy patients. Method: Data were obtained by self -reported questionnaires from 218 patients undergone mastectomy from September 1 to October 15, 2005. And data were analyzed using SPSS/PC WIN 12.0 program. For the statistical analysis of the date, frequency and percentage, mean and standard deviation, t-test, ANOVA and Scheffe test and Pearson's correlation coefficients were used. Result: The mean scores of the body image, self-esteem, and health promotion of the subjects were $41{\pm}7.40$ (range of scale : 17 to 68), $22.22{\pm}4.95$ range of scale : 10 to 40), and $130.45{\pm}23.99$ range of scale : 50 to 200), respectively. There were significant differences with the score of body image by the work type (F=4.018, p= .008), a number of child (F=3.069, p= .029), and participation with self help group program (t=68.177, p= .001). There were significant differences with the score of self-esteem by the type of religion (F=4.546, p= .002), work type (F=4.488, p= .004), post operation period (F=2.814, p= .026), and participation with self help group program (t=12.901, p= .001). There were significant differences with the score of the health promotion behavior by the type of religion (F=3.066, p= .018), economic state (F=11.765, p= .001), level of education (F=6.285, p= .001), operation site (F=.368, p=.027), family history (t=6.557, p= .011), and hope of breast reconstruction (t=7.025, p=.009). Relationship between body image and self-esteem showed moderate positive correlation (r=0.631, p= .001). The relationship between body image and health promotion behavior showed slightly positive correlation (r=0.257, p= .001). The relationship between self-esteem and health promotion behavior showed moderate positive correlation (r=0.431, p=.001). Conclusion: For the increasement of the health promotion behavior, it is needed to improve body image and self-esteem in mastectomy patients. And, It is needed to encourage to participate with self help group program in mastectomy patients.

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Clinical Study for Herbal Medicine Therapeutic Effect on the Pediatric Chronic Sinusitis using Plain Radiography and Computed Tomography (소아(小兒) 축농증(蓄膿症)의 한방(韓方) 치료효과(治療效果)에 대한 단순촬영(單純撮影) 및 CT(전산화단층촬영(電算化斷層撮影))를 이용한 임상적(臨床的) 연구(硏究))

  • Lee Hai-Ja;Park Eun-Junng;Jin Gong-Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.2
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    • pp.187-224
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    • 1999
  • Background: In recent years, pediatric chronic sinusitis patients who don't respond with antibiotics are increasing, but there are a few reports on the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective: To demonstrate the effect of herbal medicine therapy in the chronic sinusitis before and after treatment using computed tomograpy (CT) and plain radiograpy. Materials and methods: Ninty patients (45 mail and 45 femail) treated in our hospital between February 1998 and August 1999 were studied. Ages ranged from 3 to 13 years (mean age :6.5 years). Sixty two patients had a underlyiing family history (allergy or sinusitis of parents or brothers), In the past history, 68 patients had asthma, allergy of milk, atopic dermatitis, bronchiollitis and irritable bowel syndrom. Illness period was from 10 days to 96 months (mean period:12.4 month). Duration of treatment were from 25 days to 200days (mean:96 days). To ascertain the efficacy of treatment, CT in the 42 and plain radiopgrapy in the 48 patients were checked out. In the CT, three images were obtained 2cm interval on the coronal and axial plan. CT findings of the chronic sinusitis were analyzed for mucoperiostal thickening before and after treatment using 4 grades;(normal, mild, moderate, severe). Normal was defined as below 3mm thickening of mucoperiosteum; mild was 3-5mm thickening; moderate was 5mm-1cm thickening; severe was above 1cm thickening. Plain radiograpy using Water's view provided maxillary sinus, anterior ethmoid sinus, frontal sinus. Normal was defined as simillar to density between sinus and oronasal cavity; mild was defined as generally increased density with no significant mucoperiosteal thickning; moderate was partial mucosal thickening without bony hypertropy; severe was total haziness with mucoperiosteal thickening. Gamihyunggyeyungyo-tang was administered mainly. Gamigwaghyangjeungki-san, Gamizwakwi-eum and Gamihyangso-san were administered for through oral route additional symptoms Results: Of the 90 patients, 84 patients showed complete recovery (93%), 4 patients showed no significant interval change(4%) and 2 patients were aggrevated (2%). Sixty patients were severe(67%) and 26 patients were moderate (29%), 4 patients were mild(4%) The duration of treatment was varied with patient conditions (91 days in average); severe were 101.7 days, moderate were 70 days and mild were 63 days. Fifty three patients with maxillary and ethmoid sinusitis were 114 days, 35 patients with maxillary sinusitis only were 71.5 days. Fifty eight patients with both maxillary sinusitis were 94.6 days, 26 patients with either maxillary sinusitis were 65 days. The symtoms of chronic sinusitis were nasal obstruction(75%), cough(69%), purulunt or mucosal discharge(62%), lymphoid follicle(54%), postnasal dripping(49%), headache(23%) and nose bleeding(22%). Conclusion: We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis using plain radiograpy and CT. The duration of treatment may be significant assosiation with the location and degree of chronic sinusitis.

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Sequence Analysis of Small Round Structured Viruses (SRSV) Isolated from a Diarrheal Patient in Wonju (원주지역 설사 환자에서 분리한 Small Round Structured Viruses (SRSV) 염기서열 분석)

  • Jee, Young-Mee;Kim, Ki-Soon;Cheon, Doo-Sung;Park, Jeong-Koo;Kang, Young-Hwa;Chung, Yoon-Suck;Go, Un-Yeong;Shin, Young-Hack;Yoon, Jae-Deuk
    • The Journal of Korean Society of Virology
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    • v.29 no.4
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    • pp.247-259
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    • 1999
  • Small round structured viruses (SRSV) are the major ethological agents which can cause outbreaks of non-bacterial gastroenteritis or food poisoning both in children and adults. The classification of family Caliciviridae to which SRSV belong, is based on the genome encoding three open reading frames. The rotavirus is another major pathogen which causes diarrhea in young children. We examined stool specimens obtained from diarrheal patients in Wonju from which bacterial pathogens were not found. To detect causative viruses from stool specimens of patients, reverse transcription (RT)-polymerase chain reaction (PCR) or nested PCR using rotavirus or SRSV specific primers was performed. In this study, RT-nested PCR procedure which can amplify a 330 bp fragment derived from RNA dependent RNA polymerase (RDRP) region within ORF1 was applied for the detection of SRSV. For the detection of rotaviruses, a 877 bp fragment from the VP4 region of rotavirus genome was amplified. As a result, rotavirus was not detected while SRSV sequences were detected from one out of five specimens. The nucleotide and amino acid sequences of the Wonju isolate were compared with other 6 Korean isolates which have been isolated and sequenced in our laboratory. Sequence analysis revealed that the Wonju isolate was rather distinct from other Korean isolates: the Wonju isolate was closer to genogroup I of SRSV while other 6 Korean isolates belonged to genogroup II.

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The Supreme Decision on the Withdrawal of Life Sustaining Treatment: 'Madam kim' Case Reviewed by the Life Sustaining Treatment Determination Act ('김할머니' 사례로 살펴본 가정적 연명의료결정에 관한 연구 -호스피스·완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률과 관련하여-)

  • Kim, Jang Ha
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.257-279
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    • 2016
  • Recently, the Well-dying Act was legislated in Korea, and it will come into effect in August 4, 2017. This Act allows to withdraw the life sustaining treatment from impending death patients and also provide the hospice and palliative treatment to terminal patients. In the Supreme Court's case so called "Madam Kim", medical condition of Madam Kim was a persistent vegetative status owing to brain damage and her family members wanted to remove the artificial ventilation. In 2009, the Supreme Court allowed to withdraw the artificial ventilation under the specific conditions. We applied this new Well-dying Act to the Madam Kim's case hypothetically in order to know this Act can reasonably solve the problem of life sustaining treatment for dying or terminal patients. For the impending patients, the Well-dying Act has the problem not to withdraw the futile treatment due to the advance directives of patients. Vice versa, the terminal patients have no chance to withdraw the life sustaining treatment due to the this Act impose the duty to provide the hospice and palliative treatment despite of advance directives. We need to ruke out the persistent vegetative patients from the terminal patients caused by the cancer, acquired immune deficiency syndrome, chronic obstructive lung disease and chronic liver cirrhosis, In addition, we have to discuss the effect of the advance directives of terminal patients in view of self determination right.

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Induction of Apoptotic Cell Death by Aqueous Extract of Cordyceps militaris Through Activation of Caspase-3 in Human Hepatocarcinoma Hep3B Cells (Hep3B 간암세포에서 Caspase-3 활성화를 통한 동충하초 열수추출물의 Apoptosis 유도에 관한 연구)

  • Kim, Kyung-Mi;Park, Cheol;Seo, Sang-Ho;Hong, Sang-Hoon;Lee, Won-Ho;Choi, Yung-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.6
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    • pp.714-720
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    • 2008
  • Cordyceps militaris is a medicinal fungus which has been used for patient suffering from cancer in Oriental medicine. It was previously reported that C. militaris extracts are capable of inhibiting tumor growth and inducing apoptosis; however, the anti-poliferative effects of human cancer cells have been poorly understood. In this study, to elucidate the anti-cancer mechanisms of human cancer cells by treatment with aqueous extract of C. militaris (AECM), we investigated the anti-proliferative effects of AECM in human hepatocarcinoma Hep3B cells. AECM treatment inhibited the growth of Hep3B cells and induced the apoptotic cell death in a concentration-dependent manner such as formation of apoptotic bodies and increased populations of apoptotic-sub G1 phase. The induction of apoptosis by AECM was connected with a proteolytic activation of caspase-3 and caspase-8. and concomitant degradation of poly (ADP-ribose) polymerase (PARP) and ${\beta}$-catenin proteins. Furthermore, caspase-3 inhibitor, z-DEVD-fmk, significantly inhibited AECM-induced apoptosis demonstrating the important role of caspase-3 in the bserved cytotoxic effect. Taken together, these findings suggest that AECM-induced inhibition of human hepatocarcinoma cell proliferation is associated with the induction of apoptotic cell death via activation of caspase-3 and C. militaris may have therapeutic potential in human cancer.

The Clinical and Pathologic Features according to Expression of Acyl Protein Thioesterase-1 (APT1) in Stage I Non-small Cell Lung Cancer (제1기 비소세포폐암에서 APT1 발현의 임상적 의미)

  • Shin, Jung-Ar;Lee, Chang-Ryul;Byun, Min-Kwang;Chang, Yoon-Soo;Kim, Se-Kyu;Chang, Joon;Ahn, Chul-Min;Kim, Hyung-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.4
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    • pp.212-217
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    • 2010
  • Background: Acyl protein thioesterase-1 (APT1) is a cytosolic protein that may function in the depalmitoylation of numerous proteins, including the Ras family. However, the clinical role of depalmitoyl thioesterase in human cancer is not known. We evaluated the APT1 expression in lung cancer tissue and its clinicopathological findings according APT1 expression pattern. Methods: APT1 expression was examined by immunohistochemistry in the tumor tissue from 79 patients, who had undergone curative surgical removal of the primary lesion; all patients had been diagnosed with stage I non-small cell lung cancer between 1993 and 2004, at Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. Results: The APT1 expression was seen in 50 out of 79 (63.3%) cases. The positive APT1 expression was significantly related with histologic subtype and T stage, but was not influenced by differentiation. The positive APT1 expression was not significantly related to patient age, gender, or smoking history. The median follow-up duration was 10.0 years; the 5-year survival rate was 71.0%. The positive APT1 expression group showed significantly worse overall survival and worse disease-free survival without statistical significance. Conclusion: We conclude that positive APT1 expression in stage I lung cancer after surgery is closely associated with overall survival. To evaluate APT1 as a prognostic marker in lung cancer, comprehensive studies on advanced stage cases are needed.

A Case of Podostroma Cornu-Damae Intoxication Induced Pancytopenia and Skin Desquamation: Successful Treatment with Granulocyte Colony Stimulation Factor (G-CFS) (과립구집락자극인자 투여로 치료한 범혈구감소증과 피부 박리를 보인 붉은사슴뿔버섯 중독 1례)

  • Kim, Jung Seok;Kim, Gyu Won;Chung, Jae Il;Sim, Myoung Ki;Yoon, Ki Chul;Choi, Yong Hoon;Yi, Ha Ram;Choi, In Zoo;Shim, Chan Sup;Han, Joung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.50-54
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    • 2015
  • Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.

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A Study on Adherence to Dental Revisit of Scaling Patients (치석제거 환자의 치과 재방문 준수에 관한 연구)

  • Gu, Ja-Young;Lim, Soon Ryun;Lee, Su-Young
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.318-324
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    • 2015
  • The purpose of this study is to provide the basic date which is increase the number of revisits for scaling after analyzing factors that influence trend of dental revisits for 7 years. Research data was about 1,471 patients who visited S dental clinic in Seoul at 2007 for scaling. Data from January 2007 to December 2013 was collected. The subjects were divided into 3 groups by their trend in number of dental revisits for scaling: once, 2 times, 3~7 times. The data were analyzed using the chi-squire, independent-samples t-test and one-way ANOVA, binary logistic regression analysis. As a result, the trend of dental revisit for scaling is significantly decreased from first time to second time, and after 3rd time dental revisits were steadily continued. Factors affecting dental revisits for scaling are distance, family hospital, systemic disease, presence or absence of periodontal therapy. According to the results of the study, providing dental service in accordance with the patients' characteristics and increasing the dental revisits for scaling could give a positive influence to improvement of oral health.

Classification of Very High Concerns HRCT Images using Extended Bayesian Networks (확장 베이지안망을 적용한 고위험성 HRCT 영상 분류)

  • Lim, Chae-Gyun;Jung, Yong-Gyu
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.49 no.2
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    • pp.7-12
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    • 2012
  • Recently the medical field to efficiently process the vast amounts of information to decision trees, neural networks, Bayesian Networks, including the application method of various data mining techniques are investigated. In addition, the basic personal information or patient history, family history, in addition to information such as MRI, HRCT images and additional information to collect and leverage in the diagnosis of disease, improved diagnostic accuracy is to promote a common status. But in real world situations that affect the results much because of the variable exists for a particular data mining techniques to obtain information through the enemy can be seen fairly limited. Medical images were taken as well as a minor can not give a positive impact on the diagnosis, but the proportion increased subjective judgments by the automated system is to deal with difficult issues. As a result of a complex reality, the situation is more advantageous to deal with the relative probability of the multivariate model based on Bayesian network, or TAN in the K2 search algorithm improves due to expansion model has been proposed. At this point, depending on the type of search algorithm applied significantly influenced the performance characteristics of the extended Bayesian network, the performance and suitability of each technique for evaluation of the facts is required. In this paper, we extend the Bayesian network for diagnosis of diseases using the same data were carried out, K2, TAN and changes in search algorithms such as classification accuracy was measured. In the 10-fold cross-validation experiment was performed to compare the performance evaluation based on the analysis and the onset of high-risk classification for patients with HRCT images could be possible to identify high-risk data.