Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.
Objectives Postpartum blues is known to be a major risk factor for postpartum depression and can be associated with the problems of language skills, behaviors or learning skills of their children. Therefore, it is very important for clinicians to evaluate precisely and control postpartum blues. Recent studies have found that music has an effect on depressive mood and the frontal EEG asymmetry of the patients with depression. The purpose of this study was to find out the effects of music on the frontal EEG asymmetry of the mothers with postpartum blues. Method Among one hundred and seventy mothers assessed with Korean version of the Edinburg Postnatal Depression Scale (EPDS), nine mothers with postpartum blues (EPDS ${\geq}$ 10) as postpartum blues group and nine non-depressive mothers (EPDS < 10) as non-depressive mother group were included. Ten non-labored, non-depressive women were also included as a normal control group. The subjects were evaluated with the State Trait Anxiety Inventory (STAI)-X1, the Visual Analogue Scale (VAS) and the Depression Adjective Checklist-Korean version (K-DACL) and EEG twice before and after the music sesssion with the length of twenty minutes and thirty two seconds. The statistical analyses were done for A1 score (log R - log L) which were computed from the alpha powers at F3 and F4. Results No significant difference was noted in demographic data among all three groups. The postpartum blues group had higher scores in the STAI-X1, the VAS and the K-DACL compared to the other groups at baseline, and their A1 scores were lower than those of only normal controls. There was a statistically significant increase of A1 score only in the postpartum blues group after the music session. Conclusion This study suggests that the mothers with postpartum blues may have a frontal EEG asymmetry which is possibly associated with their depressive mood, and the music session can affect the frontal asymmetry positively.
The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.
Objective:The aim of this study was to evaluate the temperament and character profiles of the patients with posttraumatic stress disorder(PTSD) after burn injury. Methods:The study subjects consisted of 23 PTSD patients after burn injury, 24 patients not being diagnosed as PTSD after burn injury(non-PTSD) and 53 healthy controls. The assessment of PTSD was performed using clinician administered PTSD scale. All participants were instructed to complete the Temperament and Character Inventory(TCI), the Beck Depression Inventory and the State and Trait Anxiety Inventory of Spielberger. Results:The PTSD group after burn injury, compared with the non-PTSD group and the normal controls, had the higher novelty seeking and harm avoidance scores. But there were no differences in other dimensions in the TCI among the three groups. Conclusion:The results of this study suggest that the PTSD group after burn injury showed the specific properties of temperament and character compared with the non-PTSD group and the normal group.
Objective: There are many meditation methods used in clinical field. But the effect of meditation may be different to people's mind, and meditation itself. Now we investigate this subject with two different meditation methods which has been analyzed by heart rate variability. Method: We tried to check people's heart rate who educated meditation, before educated and during the meditation. The meditation was educated differently for each group. One is the auto genes traning, and the other is the imaginary meditation by thinking about eating and smelling favorite fruits. All of them are used to oriental psychiatry clinic patients. And we simultaneously conduct people's emotional state by SCL-90-R. Result: The result in Autogene traning group has significant difference in total power and HRV-index score between before and during the training but in imaginary meditation group has no significance: Autogene traning group has a significance in low frequency score and has increased tendency with increasing tendency of Heart rate index and Total power. Through the SCL-90-R score, the higher depression t-score, the anxiety t-score, and the hostility score is, the HRV scores such as total power, low frequency, and HRV-index much increase. and so on. Conclusion: We can guess that the Autogenes training has more significant effect than the imaginary meditation. And we can also guess that as the emotional problem is getting more severe, the effect of meditation would be much better. And we finally suggest that we should make a standard guideline of imaginary meditation, cause the imaginary meditation has so many variation.
Purpose: The purpose of this study was to identified patterns of studies and to analyze the nursing research related to the massage intervention in Korea and to improve direction of nursing research in massage intervention in Korea. Methods: The research studies related to the massage were selected from the Korean Nurses Academic Society Journal and dissertation which were conducted experimental research design the last 7 years in Korea. The total numbers of the studies were 58. Result: The study subjects were post operational state in 34.5%, healthy adult in 17.2% studies. The others dealt with infant, cancer, dementia, hypertension, preterm neonates, elderly. Types of massage were whole body in 31.1%, foot in 22.6%, hand in 17.2%, back in 13.8% studies. And Meridian massage in 17.2%. Length of massage was below 5 minutes in 17.2%, 6~10 minutes in 29.4% and 11~20 minutes in 32.8% studies. Frequency of massage was only 1 time in 25.9%, 2~5 times in 31.1% studies. Massage produced psychological and physiological effects. Positive psychologic effects were anxiety relief, pain relief, mood enhancement and fatigue relief. Positive physiologic effects on body systems were blood pressure, heart rate, edema, skin temperature, immune system, blood glucose, excretion, PMS syndrome and growth and development. Conclusion: As a result, effects of massage were almost positive. Therefore massage is useful alternative nursing intervention. But more attention research is needed to identify the objectivity instrument to measure and repeat research.
This study was carried out to investigate the effect of Self-foot reflexology (SFR) on the hypertension of workers. The purpose of the research was to evaluate: levels of knowledge, physical and emotional condition, work stress and fatigue on the hypertension of employees in the workplace. Quasi-experimental study was designed in the setting of a nonequivalent control and experimental Group applied by the pre and post test. The total subjects undertaken in the study were total of 34 employees working in three companies in Seoul. The SFR program was consisted of 6 phases. There were 2 minutes for preparation, 4 minutes for slow down, 26 minutes for base reflex, symptoms of a disease reflex and excretion reflex stimulation. Finally, there was 20 minutes relaxation in a comfortable posture and drinking hot water after blood pressure was checked in the order. This program was running 55 minutes a day everyday three times a week during the entire 8 week course. The finding showed blood pressure was reduced significantly. Moreover, the level of total cholesterol. high and low density lipoprotein cholesterol, depression, work stress, and fatigue were decreased in the study. But, they were not statistically significant except as it related to Group comparisons in time. The level of state anxiety was statistically significant between 2 Groups, but not in the time comparison of both Groups. As a summary of the study results, the SFR program was regarded as contributing to the physical and emotional promotion of employees. It had partially increased body circulations of functional organ related to the SFR sites. And, it improved relaxation of physical and mental condition through energy movement 'Chi'. Therefore, the SFR technique should be considered as an effective skill of a nursing program. Furthermore, it can be newly adopted as a nursing curriculum as a part of alternative treatment. However, it still needed to testify its effects through the review study.
In this article, the effects of stress on central nerve system and heart function and the concept of heart rate variability were reviewed. HRV(Heart Rate Variability), the periodical change of the heart rate, is indicated larger in the healthier because they respond flexibly to various sorts of facts influencing on HR. HRV analysis is largely composed of the time domain analysis and the frequency analysis. In the former the flexibility of heart function is analysed, while in the latter autonomic nerve function is examined, which is the degree of sympathetic and parasympathetic nerve activity and the state of balance. Furthermore, existence or nonexistence of disease and/or level of stress can be estimated by measuring the variability and normality of heart rate, and balance of autonomic nerve system, and through HRV biofeedback the symptoms of anxiety disorder or asthma can be reduced.
The purpose of this study is to verify the self-respect moderating effect on adolescents with emotional problems because of neglect and abusive experiences. The results are as follows: First, the level of abusive experiences was higher than that of neglect in adolescents. General characteristics including genders and individual family situations were found to be the influences causing emotional problems in adolescents. Second, adolescents with high levels of neglect and abuse experienced high levels of depression, social anxiety, aggression and physical symptoms. Third, even though self-respect did not have a strong moderating effect on the emotional problems of adolescents who suffered neglect and abuse, there was a difference between the abuse experience and the emotional problem in the inclination test results for the high and low group based on the average of the self-respect of the respondents. The results of this study suggest that the need for a stronger variable to reduce the negative emotional state among adolescents experiencing neglect and abuse is related to emotional problems.
This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.
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