• 제목/요약/키워드: Patients of Mental illness

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The Effects of Self-Management Program and Its Measurement for the Elderly with Chronic Illness in the community (국내 지역사회 거주 만성질환 노인 대상 자기관리 프로그램의 효과 및 측정도구에 대한 고찰)

  • Shin, Ga-In;Park, Hae Yean
    • 한국노년학
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    • 제40권2호
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    • pp.257-267
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    • 2020
  • The purpose of this study is to identify the effectiveness of self-management programs and the measurement used for elderly people with chronic illness living in the community. Databases used for study search were Google Scholar, RISS, and Dbpia. And research questions were selected based on the PICO framework. We searched the study published from January 2010 to September 2019 and selected the final six studies by applying inclusion criteria and exclusion criteria. As a result, the selected study had qualitative level of Level 1-2. In general characteristics of the program, nurses conducted the most programs, and the program was operated for 50 elderly people or less. In addition, the program was conducted mainly in public health centers, senior centers. The subjects were the most studies for chronic patients with hypertension. The dependent variables of the program covered the cognitive domains in all the studies, and many of the studies measured the physical domains as the dependent variables. The results of this study provide the effectiveness of self-management intervention for the elderly with chronic diseases living in the community, and highlight the need for the development of programs for chronic diseases in the community. In addition, this study suggests measuring tools related to various cognitive, physical, mental, social and quality of life of the elderly, and suggests the necessity of multidisciplinary research.

Experiences of Spousal Bereavement in Middle Aged Men (중년남성의 배우자 사별경험)

  • Park, Kyung-Bok;Kim, Boon-Han
    • Asian Oncology Nursing
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    • 제4권2호
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    • pp.143-153
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    • 2004
  • Death of spouse is the most heartbreaking stressful and inevitable tragic life event. In middle aged men who belong to the social middle class and accomplished their occupational success, experiences of spousal bereavement are great shock. The aim of this study was to find out how they overcome their mental and physical pain and to obtain the basic materials to develop suitable nursing care programs for them. The methodological approach of this study is Giorgi's phenomenological analysis meaning unit. This method also makes theme focal meaning, situated structural description and create general structural description grasped by participator's experience through situated structure description. This study performed from November 2002 to May 2004, and participators were four men. Data collected through in-depth personal interviews. which had been tapped and analysed the Giorgi's method. Finally, the five focal meaning below have been abstracted. Theme 1. Physical symptom loss of appetite, fatigue, insomnia. outbreak of illness, weight loss. Theme 2. life of spiritless lack of desire, sense of emptiness, unstableness, prosaic life. wandering. indifference of appearances, avoidance of meeting people. Theme 3. life of retrospction reflection for his wife, yearning, grief, muttering to himself, never-to-be forgotten wife, leading a lonely life. Theme 4. negative emotion reproaching, feeling hurt, marriage of daughter, feeling heavy, getting angry, sexual desire, awareness of his sinfulness. loneliness Theme 5. social support and adjustment getting his wife off his mind, curring favor with children, support and consolation by his daughter-in-law, appreciation for hospice nurse, considering remarriage, taking care of himself, good relation with his children. The result of this study showed that middle aged men bereaved of their wife by cancer need other's concern. And we have to study further to understand their experience. Until now hospice nursing is concentrated on cancer patients But from now we have to provide their families suitable nursing care programs to adjust themselves to social life before and after death of patients.

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Frequency of Cigarette Smoking Among Psychiatric Inpatients Evaluated by the Fagerstrom Test for Nicotine Dependence

  • Tanriover, Ozlem;Karamustafalioglu, Nesrin;Tezvaran, Zehra;Kaplan, Asli;Tomruk, Nesrin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.579-582
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    • 2013
  • Background: In this study our aim was to determine the rate of smoking in a sample of psychiatric in-patients with diagnoses of schizophrenia, bipolar disorder and major depression and to examine factors related to smoking status and the level of dependence in this population. Materials and Methods: A total of 160 people were included in this descriptive study. 80 were inpatients with schizophrenia, bipolar disorder and major depression and 80 people without any psychiatric diagnoses were included as a control group. The participants were interviewed face-to face using a semi-structured questionnaire and Fagerstrom Test for Nicotine Dependence was used to define smoking habits. Results: The mean age of the participants was $37.24{\pm}12.19$ years ranging from 18 to 81 years, 54.4% of the participants were (n=87) female, and 45.6% cases (n=73) were male. 70% (n=56) of the patients and 55% of the control group were smoking and the difference was statistically significant (p<0.01). Total score of Fagerstrom Test for Nicotine Dependence in the patient group was statistically significantly higher than in the control group (p<0.01). Conclusions: In our sample, the frequency of cigarette smoking and nicotine dependence among psychiatric inpatients was high, posing a high risk for smoking related diseases including cancers; therefore there should be counseling on tobacco control and smoking cessation programming targeting this population.

Initial Assessment and Care Planning in Palliative Hospice Care: Focus on Assessment Tools (호스피스 완화의료에서의 초기평가와 돌봄 계획의 수립: 평가도구를 중심으로)

  • Park, Eun Ju;Koh, Su Jin;Cheon, Jae Kyung
    • Journal of Hospice and Palliative Care
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    • 제22권2호
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    • pp.67-76
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    • 2019
  • For hospice palliative care that provides comprehensive and general care, it is necessary to use assessment tools to objectively list issues and detail care plans. The initial assessment is a process of establishing an overall direction of care by identifying the patient's symptoms, social and spiritual issues and palliative care needs on the admission day or within one day of admission. This process is also used to identify the patients' and families' awareness of the illness, prognosis, treatment options and if the Physician Orders for Life-Sustaining Treatment (POLST) has been drafted. Consisting of 13 simple questions regarding the physical, mental, social, and spiritual domains, the Needs at the End-of-Life Screening Tool (NEST) is recommended as an initial assessment tool. Using specific assessment tools, a care plan is established for the issues identified in the initial assessment within three days of admission. A multidisciplinary assessment tool can be helpful in the physical domain. The psychosocial domain evaluates psychological distress, anxiety and depression. The social domain examines an ability to make decisions, understanding of the socioeconomic circumstance, family relationship, and death preparedness. A spiritual evaluation is also important, for which the Functional Assessment of Chronic Illness Therapy-Spiritual WellBeing Scale (FACIT-Sp) or the Spiritual Health Inventory (SHI) can be used. The use of an assessment tool could not only contribute to pain mitigation a better quality of life for patients, but also provide systematic training for a multidisciplinary team; And the process itself could be a stepping stone for the better care provision.

Chronic Fatigue Syndrome (만성 피로증후군)

  • Jung, Seung-Pil;Lee, Keun-Mi
    • Journal of Yeungnam Medical Science
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    • 제24권1호
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    • pp.1-10
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    • 2007
  • The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months.), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.

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Clinical Characteristics of Korean Male Patients with Eating Disorders (남성 섭식장애 환자의 섭식장애 병리의 특징)

  • Kim, Sung-Soo;Im, Su Geun;Hwang, Boin;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • 제25권2호
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    • pp.185-192
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    • 2017
  • Objectives : The aims of present study was to investigate clinical characteristics of male patients with eating disorders. Methods : The present study included 32 male patients with eating disorders and 75 female patients with eating disorders, recruited from an eating disorders specialized clinic in a university hospital, Seoul, Korea. We compared clinical characteristics of eating disorders and comorbid conditions of depression and anxiety between men and women with eating disorders. Correlations between eating disorders psychopathology in men with eating disorders and their weight suppression(WS) were investigated. Results : There was no difference in age at presentation, age of onset, illness duration, and body mass index at presentation between genders. Male patients with eating disorders had higher rates of premorbid overweight or obesity than female patients with eating disorders had. WS in the male patients was associated with the severity of their eating disorders. Conclusions : The present study provides grounds for improved understanding for clinical features of eating disorders in males.

Restless Legs Syndrome and Quality of Life in Hemodialysis Patients (혈액투석을 받는 만성신부전 환자에서 하지불안증후군과 삶의 질)

  • Choi, Hyun-Seok;Kang, Seung-Gul;Boo, Chang-Su;Lee, Heon-Jeong;Cho, Won-Yong;Kim, Hyoung-Kyu;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • 제14권2호
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    • pp.99-106
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    • 2007
  • Objective: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. Methods: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. Results: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. Conclusion: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.

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Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity (정신장애인의 치료동의능력 평가 도구 개발 : 신뢰도와 타당화)

  • Seo, Mi-Kyoung;Rhee, MinKyu;Kim, Seung-Hyun;Cho, Sung-Nam;Ko, Young-hun;Lee, Hyuk;Lee, Moon-Soo
    • Korean Journal of Health Psychology
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    • 제14권3호
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    • pp.579-596
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    • 2009
  • This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach's alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

The Study of Pyrethroid Intoxication: The basis of Agrichemical Intoxication Survey in 2005 (Pyrethroid 중독에 대한 고찰 - 2005년도 농약 중독 실태조사를 기반으로)

  • Kim, Ah-Jin;Kim, Kyung-Hwan;Park, Joon-Seok;Eo, Eun-Kyung;Oh, Bum-Jin;Lee, Mi-Jin;Lee, Sung-Woo;Suh, Joo-Hyun;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • 제5권2호
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    • pp.99-105
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    • 2007
  • Purpose: Pyrethroid is an insecticide that produces moderate intoxication in mammals, with neither exposure to skin nor inhalation resulting in severe systemic manifestations. In 2005 we made a nationwide survey of agrichemical human intoxication. The object of this study is to analyze pyrethroid intoxications based on the 2005 survey. Methods: We prospectively collected data from 1 August 2005 to 31 July 2006 by a standard investigation protocol. We analyzed demographic data, exposure data (cause, amount, ingredients), clinical features, and courses. Results: A total of 125 cases of pyrethroid intoxication were surveyed. The mean patient age was $56.78{\pm}16.158$ years old, and the mean amount ingested was $121.85{\pm}110.732ml$. Patients were classified into four severity groups according to symptoms and mental status: the asymptomatic group (27 patients, 21.6%), the mild symptom group (48, 38.4%), the moderate symptom group (21, 16.8%), and the severe symptom group (7, 5.6%). There were statistically significant differences in mental status, severity, and mean ICU days between two groups. Admission days by severity grade for the asymptomatic, mild, moderate, and severe symptom groups were $5.49{\pm}16.051,\;3.65{\pm}4.143,\;4.59{\pm}3.335,\;and\;8.14{\pm}7.199days$, respectively (p=0.047). Conclusion: Nationwide surveillance was extremely telling in uncovering a high frequency of agrichemical intoxication in Korea. In pyrethroid intoxication, severity grading can be a useful prognostic tool.

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Slowing of the Epigenetic Clock in Schizophrenia (조현병에서 나타나는 후성유전학적 나이 가속도 감속)

  • Yeon-Oh Jeong;Jinyoung Kim;Karthikeyan A Vijayakumar;Gwang-Won Cho
    • Journal of Life Science
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    • 제33권9호
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    • pp.730-735
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    • 2023
  • In the past decade, numerous studies have been carried out to quantify aging with the help of artificial intelligence. Using DNA methylation data, various models have been developed; these are commonly called epigenetic clocks. Epigenetic age acceleration is usually associated with disease conditions. Schizophrenia is a mental illness associated with severe mental and physical stress. This disease leads to high mortality and morbidity rates in young people compared with other psychological disorders. In the past, the research community considered this disease to be related to the accelerated aging hypothesis. In the current study, we wanted to investigate the epigenetic age acceleration changes in schizophrenia patients to obtain epigenetic insights into the disease. To measure the epigenetic age acceleration, we used two different DNA methylation clock models, namely, Horvath clock and Epi clock, as these are pan-tissue models. We utilized 450k array data compatible with both clocks. We found a slower epigenetic acceleration in the patients' samples when we used the Epi clock. We further analyzed the differentially methylated CpG sites between the control and cases and performed pathway enrichment analysis. We found that most of the CpGs are involved in neuronal processes.