• Title/Summary/Keyword: Patient well-being

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Exophagectomy Combined with Resectiion of Invaded Aorta for T4 Esophageal Carcinoma. (대동맥 침습이있었던 식도암의 절제수술)

  • 신화균;이두연;김상진;김부연;이성수;금기창
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.103-106
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    • 2000
  • Advanced esophageal carcinoma which invades into adjacent organs are classified as T4 esophageal cancer,. Its complete resection without residual tumor would be difficult. Preoperative chemoradiotherapy and combined modality therapy are being tried to improve survival in patients with T4 esophageal carcinoma. In a 74-year-old man a 6cm squamous cell carcinoma of the esophagus with invasion of the thoracic aorta was detected (T4). After neoadjuvant chemoradiotherapy the patient was operated on using bio-pump with aorto-femoral cannulation. The invased segment of descending aorta was resected and reconstructed with a graft. The tumor was resected and EG anastomosis was done. The postoperative period was uneventful the patient was discharged after good condition and has been well to now.

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Baseblock Sculpturing Using the Scoring Technique for the Reconstruction of Ear (다발성 부분층 절개술을 이용한 늑연골 조각을 통한 이개재건)

  • Lee, Yoonho;Kim, Hyun Seok
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.60-66
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    • 2005
  • Total auricular reconstruction with autogenous tissue remains one of the greatest technical challenges for reconstructive plastic surgeons because of the ear's complex morphology with delicately convoluted cartilages and very thin skin. In a successfully created ear, a natural three-dimensional illusion visualized from the patient's profile, frontal, and posterior views is crucial. Accordingly ear framework should have adequate lateral aspect as well as suitable frontal aspect even before being lifted to this purpose. For this goal, rib cartilage should be harvested from three-dimensionally adequate area. It is the most essential point in framework fabrication that the baseblock should have semi-cup curvature via multiple parallel cuts made on its medial surface. Between January 1999 and May 2003, we performed 29 cases of total ear reconstruction with autogenous rib cartilage graft using this scoring technique and obtained satisfactory results, which showed more natural appearance visualized from the patient's profile, frontal, and posterior views.

Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case

  • Subedi, Asish;Bhattarai, Balkrishna;Biswas, Binay K.;Khatiwada, Sindhu
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.112-114
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    • 2011
  • Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.

Reconstruction of Disharmonious Upper Anterior Dentition by Implant Supported Fixed Prosthesis (임플란트 지지 고정성 보철물로 상악 전치부를 수복한 증례)

  • Oh, Sang-Chun;Chee, Young-Deok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.183-192
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    • 2008
  • Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.

The Effect of Voice Disorders on Quality of Life(QOL) in the Korean (한국인의 음성질환이 삶의 질에 미치는 영향)

  • 송윤경;심현섭;권기환;이경철;이용배;진성민
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.51-60
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    • 2000
  • Background and Objectives : Quality of life(QOL) is a construct representing physical, mental and social well-being. QOL has been used as a device for measuring the severity of health-related condition and treatment outcomes. As the social welfare system develops, the attention to QOL increases as well. The aims of this study was to examine whether the patients with voice disorder perceived significantly more the effects of voice disorder on QOL than nonpatient group did and if any, identify the sociodemographic risk factors influencing QOL of patients. Materials and Methods : This study asked 113 adults with voice disorders who were enrolled in Voice Clinic in the Department of Otolaryngology, Kangbuk Samsung Hospital between lune 1998 and January 1999 and 111 nonpatients to complete a questionnaire designed to elicit information about the effete of voice disorders on quality of lift. The questionnaire included items concerning sociodemographic areas, voice symptoms, job, effects of voice disorders on QOL domains(work, social, psychological, physical, and communication areas), potential risk factors to exposures, familial and medical history of voice disorders. Results : The sociodemographic characteristics of the patient group are as follows : (1) 75.2% of total patient group were female and the rest were male. (2) Age of total patient group ranged from 20 to 65 years. Hoarseness was the most commonly reported complaints, followed by complaints of high note difficulties during singing and voice fatigue. The patient group perceived effects of voice disorders on the areas of work, social, psychological, physical and communication more adversely than the comparison group did (p<0.05). QOL impairments were evaluated as a function of age, gender, education, and income, controlling other independent effects. The results were that (1) age was significantly associated with work problems and (2) gender and income were significantly associated with psychological problems. Conclusions : The findings indicated that the patients with voice disorders would perceive markedly adverse effect on all QOL domains, that is, work, social, psychological, physical, communicational areas. Therefore, the results of study suggest that lurker investigations about the nature of voice disorders, the prevention, treatment, and coping strategies are needed in the future.

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Effect of Informational Support by Hospice Team on Family Caregivers of Terminally III Cancer Patient (말기암 환자 가족에 대한 호스피스 팀의 정보적 지지 제공 효과)

  • Lee, Hye-Won;Kim, Chung-Nam;Park, Myung-Hwa
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.175-186
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    • 2001
  • To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients. 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support. Spielberger's state anxiety inventory. CES-D. and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team, he data were analysed frequency. percentage. Wilcoxon Singed Ranks Test with SPSS Win l0.0/PC. The results obtained from this study were as follows; 1. The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045. p=0.002). 2. The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z =-3:348. p=0.001). 3. The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641. p=0.000). 4. The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422. p=0.673). In conclusion. the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.

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Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression

  • Cho, Youngdae;Jeon, Yongwoo;Jang, Sung-In;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.2
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    • pp.100-108
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    • 2018
  • Objectives: Family members are often cancer patients' primary source of social and emotional support and make a major contribution to how well patients manage their illness. We compared the prevalence of depression in the family members of cancer patients and the general population. Methods: This study used the data from the fourth, fifth, and sixth rounds of the Korea National Health and Nutrition Examination Survey. The variable of interest was the presence of a cohabitating cancer patient in the family and the dependent variable was the presence of diagnosed depression. Results: The odds of having medically diagnosed depression in those with a cohabitating cancer patient in the family were significantly higher than among those who did not have cancer patients in their families (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.12 to 2.17; p=0.009). The OR for females was 1.59, and this increase was statistically significant (95% CI, 1.09 to 2.31; p=0.02). Conclusions: We need to invest more effort into diagnosing and managing depression in the family members of cancer patients. This will have an impact both on their quality of life and on the well-being of patients, as supporters and caregivers play an instrumental role in helping patients manage their illness.

Successful Transition from Pediatric to Adult Care in Inflammatory Bowel Disease: What is the Key?

  • Kim, Jeongseok;Ye, Byong Duk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.28-40
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    • 2019
  • The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

Effects of Video-guided Education for Primary Family-caregivers of Stroke Patients (뇌졸중 환자의 주간호제공자를 위한 비디오재활교육의 효과)

  • Cho, Bok-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.2
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    • pp.237-246
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    • 2011
  • Purpose: Family-caregivers of stroke patients usually go through hardship and life style changes during the protracted course of a family member's rehabilitation. There is need for programs to educate family-caregivers to better manage the medical crisis. In this study an evaluation was done of the degrees of burden and well-being experienced by primary family-caregivers following video-guided education (VGE) on rehabilitation and family lifestyle changes. Method: Fifty-eight primary family-caregivers of stroke patients on a neurological ward were divided into VGE (29) and control (29) groups. VGE was started within 7 days of patient admission. Interventions included VGE, counseling, and demonstration - re-demonstration. The control group received standard education but not VGE. Data were analyzed using Chi-square test, t-test, ANCOVA, and Pearson correlation coefficients with the SAS program. Results: The VGE group had a significantly lower score for total burden (F=7.19, p=.010) and for sub-scale of time-dependent burden (F=8.44, p=.005) than the control group. There was a negative correlation between primary family-caregiver burden and well-being (r=-.7151, p<.001). Conclusion: Results suggest that the rehabilitation program using VGE was an effective nursing intervention to reduce the burden of primary family-caregivers of stroke patients.

Exploring Communication Difficulties in Pediatric Hematology: Oncology Nurses

  • Citak, Ebru Akgun;Toruner, Ebru Kilicarslan;Gunes, Nebahat Bora
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5477-5482
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    • 2013
  • Background: Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. Objective: This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. Materials and Methods: It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Results: Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Conclusions: Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.