• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.314-327
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• 1999

In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.870-879
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• 2010

Objective : This study is about stroke risk factors which may differ between countries. Methods : We recruited 1725 ischemic stroke patients from multiple-centers. We analyzed stroke risk factors: hypertension, diabetes mellitus, dyslipidemia, depression, cardiac source, smoking, waist-to hip ratio, alcohol intake, physical activity, and psychosocial stress. We then compared risk factor results from other countries (the INTERSTROKE study) with this study. Results : 10 risk factors are related to stroke incidence. They were somewhat different between this study and the INTERSTROKE study. Conclusions : Hypertension is the most important risk factor of stroke, and other 9 risk factors also should be managed to prevent stroke incidence. Frequency of risk factors were different from the INTERSTROKE study. I think it could be partly due to differences of ethnicity and age. More studies are needed to describe characteristics of risk factors of Koreans.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1005-1014
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• 2009

Purpose:Epilepsy of child may cause high level of psychosocial difficulties for parents including stigmatization and stress and therefore worsen their quality of life (QOL). The purpose of this study was to evaluate the mediating effect of perceived stigma against epilepsy on QOL among parents with epileptic child. Methods:Two hundred and sixty parents of epileptic child recruited from five separated university hospital child neurology clinics specializing in epilepsy completed a demographic questionnaire, a medical questionnaire, a perceived stigma questionnaire and the Ro's Quality of Life Inventory, a popular tool for evaluating QOL of adults in Korea which is composed of 6 domains and 47 questions. Data was analyzed with SPSS 14.0 program using frequency analysis and descriptive analysis and with AMOS 7.0 program using Structural Equation Model (SEM) analysis. Results:The level of parents' QOL was relatively fair. SEM analysis on the quality of life level of parents showed that all variables (especially having religion, the monthly income, employment state, age of child, the leisure time, the perceived stigma level against epilepsy, and seizure frequency) directly affect the quality of life level of parents and that disease-related variables also affect the quality of life level of parents indirectly through the mediating factor (the perceived stigma), where the indirect effect is large with the existence of combined disabilities. The total effect on the quality of life level of parents is large with the existence of combined disabilities, the perceived stigma level, the leisure time, having religion, and the monthly income. Conclusion:The results of this study indicated that many factors including parents' perceived stigma may affect the quality of life of parents with epileptic children directly, and that some disease-related factors may affect indirectly through a mediating factor, the perceived stigma. Multidisciplinary collaboration would be imperative for their welfare.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.497-507
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• 2018

Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Women's Health Nursing
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• v.7 no.4
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• pp.536-546
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• 2001

The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.296-310
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• 2000

During the past 10 years, concern for community people's health has increased together with the changes. Public health policies and studies for community people's health, however, have influenced those in childmaternal health care to want more general coverage and studies of health and wellness. Particularly, the study of community people's health in the extent an island area is almost rare as that personal and the material benefits in this area are lacking of community people's work is large, and the basic elements of living, such as diet and elimination, are irregular due to the schedule of the tide. Thus, there are many potential health problems. In this regard, the study attempted to understand the health problems of island community people and to provide a basis for developing health promotion and health education programs. In collecting data for the study, face to face interviews were made through a structured questionnaire from October 1 to December 30, 1996. Collected data were analyzed with the SAS statistics program, descriptive statistics, t-test and ANOVA. Subjects' health status was examined by classifying into such categories as their health perception, complaints of health problem, related lifestyle, psychosocial health staus, the result of examination is as follows; 1. For subjects' health perception, 26.9% of the subject answered not sick, but not so healthy'; 30.9% thought they were healthy, while 22.9% answered that they were not healthy. 2. For the health problem complaints many complained of pains in their muscles and skeletal system, especially knee joint pain. Women's health problems related with breast and the reproductive system included 52.3% of cases doing breast self examination, while 56.55% received the cervical cancer screening test. In men's health problems, 44.2% of subjects answered that they have moderate to severe BPH(Benign Prostatic Hypertrophy) symptom. 3. There were statistically a significant difference in the degree of physical health according to marital status(p=0.0028), occupation(p=0.0442), income(p=0.0357). 4. For stress status, 17.2% was to need the intervention, 50.2% was to need observation. 5. The mean score of self-esteem was 27.7 showing a relatively high score. 6. For the rate of smoking, 37.7% used to smoke, while 28% used to take alcohol. 7. The rate of substance abuse was 45.9% of subjects. 8. Most of subjects' health behaviors included most of the acupuncture (52%). 9. The rate of subjects receiving comprehensive medical testing was 34.36% while 34.78% did after care managing behavior. 10. For the obesity grade, 53% is normal weight, low-weight 32.8%, obesity 33%. 11. For nutrition status, 78.7% illy balanced to need intervention of nutritional education. 12. For 78.7% of subjects, muscle strength and 40.7% of stretching were not good enough to need health education on physical exercises. Therefore, based on the results, appropriate health education programs need to be developed to promote health of community people on an island.

• Journal of Preventive Medicine and Public Health
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• v.38 no.4
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• pp.391-400
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• 2005

Objective : This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. Methods : A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Results : Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. Conclusions : The perceived economic hardships predicted the health status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.68-71
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• 2012

Purpose: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. Methods: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. Results: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. Conclusion: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.197-220
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• 1997

The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.