• Journal of Chest Surgery
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• 제55권2호
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• pp.108-117
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• 2022

Background: The efficacy of telemedicine among cancer survivors is uncertain. The Smart After-Care Program (SAP), which is an interactive, smartphone-based remote health monitoring system, was developed to help patients manage their health after leaving the hospital. This study was designed to evaluate the efficacy of our remote health care program for lung cancer patients. Methods: We enrolled 50 patients with lung cancer. Self-monitoring devices were supplied to all patients, who were instructed to enter their daily vital signs and subjective symptoms to the Smart After-Care app. The app also provided information about rehabilitation exercises and a healthy diet for lung cancer patients. All patients received health counseling via telephone once a week and visited an outpatient clinic during weeks 6 and 12 to assess satisfaction with the SAP and changes in quality of life and physical performance. Results: Overall satisfaction with the SAP was very high (very good, 61.9%; good, 26.2%). In the multivariate analysis to identify factors affecting satisfaction, the distance between the patient's residence and the hospital was the only significant independent factor (p=0.013). Quality of life improved along all functional scales (p<0.05). Muscle strength significantly improved in the lower limbs (p=0.012). Two-minute walk distance also significantly improved (p=0.028). Conclusion: This study demonstrated that the SAP was acceptable for and supportive of patients with reduced pulmonary function after lung cancer treatment. The SAP was found to be particularly useful for patients living far from the hospital.

• 한국응용과학기술학회지
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• 제40권4호
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• pp.660-673
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• 2023

본 연구는 성인 흡연자의 심근경색증 조기 증상 인지 정도를 파악하고 인지와 관련된 요인을 분석하기 위해 진행되었다. 2021년 지역사회 건강조사 원시 자료를 활용한 서술적 조사연구로 조사 완료자 229,942명 중 본 연구에 해당하는 설문에 응답이 불충분한 대상자 18,343명을 제외한 210,899명을 연구대상자로 선정하여 SAS 9.4 program을 이용하여 표본 분석, 빈도, 백분율 등의 기술통계, 카이 제곱 검정, 복합표본 로지스틱 회귀분석을 사용하였다. 나이, 혼인 여부, 교육수준, 금연계획 여부, 건강검진_암 검진 수검 여부, 당뇨병 진단 여부, 주관적 건강 수준, 사회 물리적 환경이 심근경색증 조기 증상 인지와 유의한 관련이 있었다. 연구 결과를 바탕으로 심근경색증 발생 위험이 높은 고위험 집단에 대한 적극적인 홍보 및 교육이 필요하다.

• 대한한의학회지
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• 제26권3호
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• pp.80-97
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• 2005

Backgrounds : In recent years there has teen renewed interest in the importance of 8-constitution medicine as evidenced by growth of research in this field. Although diagnosis by 8-constitution depends on pulse types, it still is subjective and thus could be insignificant. Therefore, diagnosis based on objective characteristics is essential. Objectives : The purpose of this study was to find objective characteristics of the 4-constitution groups {木(Mok; hepatonia, cholecystonia), {土(To; pancreotonia, gastrotonia), {金(Gum; pulmotonia, colonotonia), {水(Soo; renotonia, vesicotonia)} in 8-constitution for further diagnosis and therapy. Also, some significant clinical tendencies of 4-constitution groups were studied. Methods : From Nov. 2001 to Apr. 2004, data were collected through a questionnaire given to 720 patients who were classified into one of 8 constitutions according to their pulse types and their responses to constitution-based acupuncture therapy. The questionnaire was composed of 80 items which were about personality, physical shape, habit, physiological and pathological symptoms, response to drugs, favorites and responses to various foods. The data were statistically analyzed by cross-tabulation and one-way analysis of variance, and SPSS V10.0.7PC was used. Results : The results are summarized as follows: 1) Among participants, proportions of hepatotonia, pancreotonia, and cholecystotonia were higher than those of vesicotonia, pulmotonia, colonotonia, renotonia, grstrotonia. 2) 52 items of 80 variances showed significant differences by gender, 3) 13 items were highly correlated with 4-constitution groups in males, and 26 items in fremales. 4) 22 items showed significant group differences among 4-constitution groups in males, and 41 items in females. Also, for each item 4-constitution groups were sorted according to their means, so that the constitutional tendencies were objectively figured out by personality, shape, habit, physiological and pathological symptoms, response to drugs, favorites and responses to foods. Conclusions : Most clinical characteristics of 4-constitution groups found in this study coincided with those from the previous ones in this fold. Thus, classifying patients into one of the 4-constitution groups based on significant objective characteristics is of great benefit to diagnosis and therapy. further study should be followed to improve proper therapy for each constitution.

• 대한간호학회지
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• 제30권1호
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• pp.122-136
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• 2000

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

• 대한간호
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• 제28권3호
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• pp.52-67
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• 1989

True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.597-606
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• 2016

본 연구는 초등학생의 변비 발생률을 알아보고, 변비유무에 따른 식습관, 운동 활동 시간, 스트레스 및 학교화장실 환경에 대한 인식의 차이를 파악하고, 변비 발생률과 관련요인을 알아보기 위한 서술적 조사 연구이다. 연구 대상자는 전라남도의 6개 초등학교의 재학 중인 3, 4, 5, 6학년 741명을 대상으로 하였으며, 자료수집 기간은 2014년 4월 30일부터 2014년 5월 12일까지 설문조사 하였다. 수집된 자료는 실수와 백분율, 카이제곱 검정, 독립표본 T 검정, 이변량 로지스틱 회귀분석을 하였다. 연구결과, 초등학생의 변비 발생률은 23.9%이었으며, 변비 발생률과 관련요인으로는 화장실 선호도, 쉬는 시간 배변 여부, 하루 식사 횟수, 아침 결식 횟수, 식사량, 학원수업 시간, 인터넷 이용시간, 스트레스, 학교화장실 환경에 대한 인식이었다. 특히 스트레스가 '상'의 경우 스트레스가 '하'보다 5.44배의 높은 변비 발생률을 보였다. 주관적인 증상만으로 변비를 진단하는 것은 한계가 있으므로 자세한 문진과 신체검진을 포함한 변비 발생률에 대한 파악이 필요하며, 초등학생의 변비 예방을 위한 교육 및 관리의 노력이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.357-364
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• 1988

충청북도 단양지역 착암 근로자 79명과 착암기를 사용하지 않는 광산 근로자 39명을 대상으로 1987년 6월 10일부터 1987년 6월 19일까지 면접 조사 및 집단 검사를 시행하여 다음과 같은 결과를 얻었다. 1. 창백지(white finger)는 오른쪽 손에 더 많이 나타났다. 2. 창백지 발현에 진동 노출량, 연령, 음주 및 흡연 여부가 통계학적으로 유의한 변수로 선정되었다. 3. 진동 증후군 증상자의 수지부 통각역치가 대조군에 비해 증가되었다. 4. 냉수 침적후 진동 증후군의 피부온도가 대조군에 비해 낮았으며 회복은 대조군에 비해 지연되는 경향을 보였다.

• 농약과학회지
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• 제9권4호
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• pp.287-291
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• 2005

농업기술의 발전으로 인하여 농약사용은 증가하게 되었으며, 이에 따라 농약사용으로 인한 건강영향에 대한 관심도 증가시켰다. 그러나 농약의 사용과 노출된 근로자의 주관적인 건강상태에 관한 연구는 아직 없는 형편이기 때문에 본 연구에서는 농약 노출과 주관적인 건강상태의 연관성에 관한 연구를 시도하고자, 집단의 건강상태를 알기 쉽고 농촌지역의 노인인구를 대상으로 쉽게 설문을 할 수 있는 SF-12를 이용하여 농약과 건강상태의 상관관계를 분석하였다. 조사 대상은 농약을 많이 사용하는 것으로 알려진 강원도 일부지역 고랭지 농업인을 대상으로 하였다. 분석결과 고랭지 농업인이 일반 농업인보다 전체 노출지수나 살충제 노출지수, 제초제 노출지수, 급성 중독 증상 지수 모두 높았다. 그러나 본 연구는 단면적 연구이고 건강상태에 영향을 미칠 수 있는 다양한 요인들이 통제가 안 되어 있다는 제한점을 가지고 있으나 농약과 건강수준, 특히 만성적인 건강 장해를 일으킬 수 있다는 점을 제시하여 농약의 과다사용을 방지하고 농약사용에 대한 보건학적 주의가 필요하다는 점을 제시할 수 있으며 향후 이에 대한 체계적인 연구가 이루어져야 할 필요가 있다.

• Tuberculosis and Respiratory Diseases
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• 제41권2호
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• pp.127-134
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• 1994

연구배경 : Diffuse panbronchiolitis(DPB)는 1966년 일본에서 처음 기술된 만성 염증성 호흡기질환으로 기관지천식, 폐기종, 만성기관지염, 기관지확장증, 또는 폐포염과는 구별되는 질환이며 주로 일본에 많이 보고되었고, 중국 및 서구의 몇나라에서 증례보고가 있었으며, 본 교실에서도 최근 한국인에서의 DPB 환자의 임상적특징을 보고한 바 있다. DPB는 과거에 대증요법과 steroid 치료이외에 특별한 치료법이 없어 호흡부전으로 진행하여 사망하는 아주 예후가 좋지 않은 질환으로 알려졌었으나, 최근에 erythromycin의 소량장기투여가 효과가 있다는 보고가 나오고 있다. 본 교실에서는 1989년 9월부터 1993년 8월까지 서울대학교병원에서 병리학적 또는 임상적으로 DPB로 진단받은 환자 19명 중 erythromycin으로 치료하면서 6개월 이상 추적하고 있는 14명의 환자를 대상으로 erythromycin의 소량장기투여 효과를 분석하여 보고하고자 한다. 방법 : Erythromycin을 250 mg b.i.d.로 투여하고 치료전, 치료 3개월, 6개월 및 12개월 후에 환자의 자각증상, 흉부청진소견, 폐기능검사, 흉부X선검사의 변화를 관찰하였다. 결과: 1) 평균 치료 및 추적기간은 $16.4{\pm}6.5$개월이었으며 14명 전원의 환자가 erythromycin 투여 2~3개월 이내에 자각적증상(호흡곤란, 객담배출)의 호전을 보였고 1년 후 54.5%의 환자에서는 완전히 증상이 소실되었다. 2) 흉부청진상 14명 전원의 환자에서 수포음 또는 천명음의 감소가 있었고 1년 후 63.6%의 환자에서는 완전히 소실되었다. 3) FVC 및 $FEV_1$은 치료 3개월간 현저히 증가하며 이후 치료 1년까지 서서히 증가하여 거의 정상수준으로 회복되었다. 그러나 $FEV_1/FVC$는 큰 변화가 없었고 치료 1년 후 약간 증가하였다. 4) 흉부 X-선상 14명 전원의 환자에서 결절성병변의 감소가 관찰되었으나, 기관지확장증의 소견은 큰 변화가 없었다. 1년 후 36.4%의 환자에서는 정상 흉부X-선 소견을 보였다. 5) 1명의 환자가 14개월 치료후 소화장애로 erythromycin의 투여를 중단하였으나, 현재 1년 후까지 추적검사상 재발의 증거는 없었다. 1명의 환자는 16개월 치료 후 증상이 없어서 투약을 중단하였으나 1개월 후 다시 증상이 악화하여 다시 치료를 시작하여 호전되었다. 결론 : 이상의 결과로 erythromycin의 소량장기투여는 DPB환자의 치료에 괄목할 만한 효과를 보임을 알 수 있으며, 투여기간에 대해서는 향후 연구가 필요하리라 생각된다.

• 수면정신생리
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• 제12권1호
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• pp.50-57
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• 2005

목 적：본 연구에서는 주요우울장애를 동반한 공황장애 환자들과 동반하지 않은 공황장애 환자들을 대상으로, 환자들이 경험하는 공황장애의 임상 양상 및 증상의 심각도의 차이를 확인하고, 주관적인 증상 평가 이외에 불안을 나타내는 생리적 지표인 자율신경계 기능의 차이도 함께 알아보고자 하였다. 방 법：DSM-IV 진단 기준으로 공황장애 환자들에서 주요우울장애가 공존하는 것으로 진단된 19명과 주요우울장애가 공존하지 않는 것으로 진단된 60명을 대상으로 첫 외래 방문시 공황 증상으로 인한 고통 정도와 회피 정도를 측정하는 기본 기록지와 기타 자기 보고식 설문지를 실시하였으며, 자율 신경계 기능을 평가하기 위해서 객관적, 생리적 지표로 Heart Rate Variability(HRV)를 측정하고 환자들이 경험하는 공황장애의 심각성을 평가하기 위해 임상가들에 의해 Clinical Global Impression(CGI)과 Panic Disorder Severity Scale(PDSS)을 시행하여 객관적으로 평정하였다. 자료 분석을 위해 환자들이 보고한 각 임상 척도 점수 및 임상가 평정 점수를 주요우울장애가 공존하는 공황장애 환자군과 그렇지 않은 공황장애 환자군에 따라 t-test를 통해 비교하고, 두 집단간 HRV 양상을 비교하기 위해서 연령을 공변인으로 설정하고 ANCOVA를 실시하였다. 결 과：주요우울장애가 동반된 공황장애 환자들은 공황장애로만 진단된 환자들에 비해 주관적으로 호소하는 우울이나 불안 수준이 더 높았으며, 불안 민감도나 신체 증상에 대한 예민성도 더 많이 호소하는 경향이 있었다. 또한 부정적인 일상생활에서 자신을 비하하고 낙담하게 하는 부정적인 자동적 사고 경향이 더 높았으며, 자기 자신을 고양하고 미래를 희망적으로 지각하는 긍정적인 자동적 사고 경향은 더 낮은 것으로 나타났다. CGI와 PDSS와 같은 객관적 평정 척도에서도 우울증이 동반된 공황장애 환자들의 증상 심각도가 더 높은 것으로 나타났다. 반면, 주요우울장애를 동반한 환자들의 심박 변이도가 보다 낮은 경향이 있었지만 두 군사이에 통계적으로 유의한 차이는 없었다. 결 론：본 연구 결과로 주요우울장애를 동반한 공황장애 환자들이 공황장애만을 지닌 환자들에 비해 임상 양상이 심하고 더 많은 고통을 겪는다는 것을 알수 있었다. 그러나 HRV 지표에서는 두 집단간 유의한 차이가 관찰되지 않았다. 향후 더 많은 대상자를 포함한 연구가 시행된다면 주요우울장애의 동반 여부에 따른 자율신경계 기능의 차이에 대해 더 많은 이해가 가능하리라고 기대된다.