• Title/Summary/Keyword: Severity of illness

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Uncertainty and Transfer Anxiety of Pediatric Patients' Mothers upon Discharge from the Pediatric Intensive Care Unit (소아중환자실 퇴실 시 환아 어머니의 불확실성과 전동불안)

  • Song, Min-Kyung;Bang, Kyung-Sook
    • Korean Parent-Child Health Journal
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    • v.15 no.2
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    • pp.80-88
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    • 2012
  • Purpose: This study was done to investigate the level of uncertainty, transfer anxiety, and to identify the participant's characteristics those influence them by targeting the mothers of transferred patients from the pediatric Intensive Care Unit (PICU) to the general ward. Methods: This study was a descriptive correlational study. The participants were 94 mothers of children who had been scheduled to transfer from the PICU. Results: The item mean score for uncertainty was 2.16 (4 scale), transfer anxiety was 2.15 (4 scale). There were statistically significant positive correlation between uncertainty and transfer anxiety (r=.591). The level of uncertainty significantly differed according to education level (p=.035), duration of marriage (p=.043), and monthly income (p=.022). The level of transfer anxiety significantly differed according to religion (p=.044), duration of marriage (p=.043), and severity of illness at transfer (p=.047). Conclusion: In order to reduce the transfer anxiety and uncertainty of the mothers of patients, efficient communication with medical staff and clear informations are needed to reduce ambiguity. Also, standard protocol should be developed for improving communication among medical staffs.

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Evaluating the Validity of the Pediatric Index of Mortality Ⅱ in the Intensive Care Units (소아중환자를 대상으로 한 PIM Ⅱ의 타당도 평가)

  • Kim, Jung-Soon;Boo, Sun-Joo
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.47-55
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    • 2005
  • Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919~0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

Demand Survey for Application of Environmental Therapy for Atopic Dermatitis

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.35 no.2
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    • pp.34-40
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    • 2014
  • Objective: This study aimed to investigate the demand for natural environment therapy among parents of patients with atopic dermatitis. Methods: The questionnaire-based survey was conducted on the parents of 310 patients with atopic dermatitis (158 male and 152 female, median age 8 years, ranging from 2 to 21 years). The questionnaire consisted of 10 questions including demographic information, preference of environmental therapy and related choices. Results: Regardless of illness severity or gender, parents agreed with the importance of environmental therapy in treatment for atopic dermatitis. 55.2% of parents had considered moving to the countryside for their children with atopic dermatitis. 74.5% of parents answered positively to the possibility of movement to an atopy-free village, and this rate was significantly higher in parents of patients with severe symptoms (p < 0.05). Educational facilities and eco-environment were considered to be the most important factors in their decision. In addition, parents opted for organic food cooperatives, which was also felt necessary for their children suffering from atopic dermatitis. Conclusions: This study is the first report suggesting the extent of demand for environmental therapies among patients with atopic dermatitis. This information will be helpful in developing therapeutics using the natural environment in Korean medicine.

A Pilot Examination of Oxidative Stress in Trichotillomania

  • Grant, Jon E.;Chamberlain, Samuel R.
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1130-1134
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    • 2018
  • Objective Trichotillomania is a relatively common illness whose neurobiology is poorly understood. One treatment for adult trichotillomania, n-acetyl cysteine (NAC), has antioxidative properties, as well as effects on central glutamatergic transmission. Preclinical models suggest that excessive oxidative stress may be involved in its pathophysiology. Methods Adults with trichotillomania provided a blood sample for analysis of compounds that may be influenced by oxidative stress [glutathione, angiotensin II, ferritin, iron, glucose, insulin and insulin growth factor 1 (IGF1), and hepcidin]. Participants were examined on symptom severity, disability, and impulsivity. The number of participants with out-of-reference range oxidative stress measures were compared against the null distribution. Correlations between oxidative stress markers and clinical measures were examined. Results Of 14 participants (mean age 31.2 years; 92.9% female), 35.7% (n=5) had total glutathione levels below the reference range (p=0.041). Other oxidative stress measures did not have significant proportions outside the reference ranges. Lower levels of glutathione correlated significantly with higher motor impulsiveness (Barratt Impulsiveness Scale sub-score) (r=0.97, p=0.001). Conclusion A third of patients with trichotillomania had low levels of glutathione, and lower levels of glutathione correlated significantly with higher motor impulsiveness. Because NAC is a precursor for cysteine, and cysteine is a rate limiting step for glutathione production, these results may shed light on the mechanisms through which NAC can have beneficial effects for impulsive symptoms. Confirmation of these results requires a suitable larger follow-up study, including an internal normative control group.

Vascular health late after Kawasaki disease: implications for accelerated atherosclerosis

  • Cheung, Yiu-Fai
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.472-478
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    • 2014
  • Kawasaki disease (KD), an acute vasculitis that primarily affects young children, is the most common acquired paediatric cardiovascular disease in developed countries. While sequelae of arterial inflammation in the acute phase of KD are well documented, its late effects on vascular health are increasingly unveiled. Late vascular dysfunction is characterized by structural alterations and functional impairment in term of arterial stiffening and endothelial dysfunction and shown to involve both coronary and systemic arteries. Further evidence suggests that continuous low grade inflammation and ongoing active remodeling of coronary arterial lesions occur late after acute illness and may play a role in structural and functional alterations of the arteries. Potential importance of genetic modulation on vascular health late after KD is implicated by associations between mannose binding lectin and inflammatory gene polymorphisms with severity of peripheral arterial stiffening and carotid intima-media thickening. The changes in cholesterol and lipoproteins levels late after KD further appear similar to those proposed to be atherogenic. While data on adverse vascular health are less controversial in patients with persistent or regressed coronary arterial aneurysms, data appear conflicting in individuals with no coronary arterial involvements or only transient coronary ectasia. Notwithstanding, concerns have been raised with regard to predisposition of KD in childhood to accelerated atherosclerosis in adulthood. Until further evidence-based data are available, however, it remains important to assess and monitor cardiovascular risk factors and to promote cardiovascular health in children with a history of KD in the long term.

Effect of Socheongryong-tang on Punghan and Pungyeol Type Common Cold : A Double Blind, Placebo Controlled Study (풍한형 및 풍열형 감모에 대한 소청룡탕의 효과 - 이중맹검, 위약대조군연구)

  • Park, Yang-Chun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.2
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    • pp.524-529
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    • 2005
  • Socheongryong-tang(SCRT) is widely used to treat the common cold. The purpose of this study was to evaluate the efficacy of SCRT on Punghan type(風寒型) and Pungyeol type(風熱型) common cold. 98 registered students with commom colds of recent onset were randomized to the double blind, placebo-controlled study. SCRT extract in capsule, $5.4g(1.8g{\times}3cap)$, orally dissolved 3 times a day. The severity of illness was assessed by the physician, using a 5-point scale on start and finish. In Pungyeol type common cold, no statistically significant differences were detected between the SCRT and placebo groups for any of the measured outcomes. In Punghan type common cold, SCRT significantly reduced rhinorrhea (p=0.034) and nasal stuffiness (p=0.048) compared with placebo. This study shows that SCRT is effective in treating cold symptoms in Punghan type common cold. If patients with cold are able to be administered SCRT according to common cold type, the benefit would be expected to increase.

Fever and rash (발열과 발진)

  • Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.132-137
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    • 2007
  • Patients with febrile illness and skin rashes need full and immediate attention. In general, these diseases show mild manifestations and good prognosis. However, causalities of some diseases with fever and rash may be life threatening or trivial. So, the differential diagnosis for those patients is extensive. A through history, a careful physical examination and close observation of clinical progress are very helpful and essential to confirming the diagnosis. Histories of recent travel, drug or specific food ingestion, exposure to human or an animal source of infection may be useful to discover the cause. Although laboratory tests can be useful in making the diagnosis, laboratory results usually are not available immediately. Knowledge and experiences of such diseases may be helpful to reduce the differential diagnosis to a few major possibilities. Rashes can be categorized as petechial, maculopapular, vesicular, urticarial and erythematous. Potential causes include infectious pathogens such as virus, bacteria, rickettsiae, spirohetes, connective tissue diseases, allergic diseases and heamto-oncologic diseases. Because the severity of these diseases can vary mild to life threatening, physicians must perform prompt management decisions regarding empirical therapies. In this article, the differential etiological diagnosis of each type rash is reviewed and discussed, and with emphasis on intensive care of life threatening febrile diseases with rashes that are seen in our country.

Physician Utilization and its Determinants in Rural and Urban Slum Areas (일부 농촌주민과 도시영세민의 상병 및 의료이용에 관한 연구)

  • Lee, Jin-Hee;Ko, Kee-Ho;Kim, Yong-Sik;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.404-418
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    • 1988
  • The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing facotrs explained 17.1 and 8.9% correspondingly.

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A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area (일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구)

  • Jang, In-Sun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.2
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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Symptom severity, Functional Impairment, and Personality Profiles between Partial and Full Post-traumatic Stress Disorder Patients among the Adolescent Survivors from the Incheon Fire Disaster (인천 화재사건 청소년 생존자를 대상으로 한 PTSD 하위유형간 증상, 기능 및 기질성격 특성 비교연구)

  • Hwang, Seo Hyun;Lee, Hong Seock;Lee, Sang Kyu;Lee, Heung Pyo;Jeon, Chul Eun;Lee, So Young;Lee, Yong Ku
    • Anxiety and mood
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    • v.7 no.2
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    • pp.92-100
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    • 2011
  • Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.