• 제목/요약/키워드: Subjective global assessment

검색결과 58건 처리시간 0.023초

Assessment of Malnutrition of Dialysis Patients and Comparison of Nutritional Parameters of CAPD and Hemodialysis Patients

  • Wi, Jin Woo;Kim, Nam-Ho
    • 대한의생명과학회지
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    • 제23권3호
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    • pp.185-193
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    • 2017
  • Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country

  • Shaimaa Sayed;Mortada H. F. El-Shabrawi ;Eman Abdelmonaem ;Nehal El Koofy;Sara Tarek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권4호
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    • pp.213-223
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    • 2023
  • Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

노인 아증후군적 우울증 환자의 인지기능 및 삶의 질 저하 (Cognitive Impairment and Decreased Quality of Life in Elderly Patients with Subsyndromal Depression)

  • 류재성;김문두;이창인;박준혁
    • 생물정신의학
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    • 제20권2호
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    • pp.45-53
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    • 2013
  • Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

비타민 B 복합제가 스트레스에 의해 유도된 면역변화에 미치는 영향 (The Effect of Vitamin B-Complex on Stress-induced Immune Alteration)

  • 고경봉;유순형
    • 정신신체의학
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    • 제7권2호
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    • pp.196-202
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    • 1999
  • 본 연구의 목적은 비타민 B복합제가 스트레스에 의해 유도된 변역변화에 대한 효과를 알아보기 위해 조사되었다. 대상은 의과대학 학생들로 시험 4주전, 시험 2주전, 시험기간 세 차례를 모두 완료한 21 명으로 하였다. 이들 중 10명은 비타민 투여군으로, 11명은 비투여군으로 구분하였다. 스트레스지각 및 정신병리를 평가하기 위해 global assessment of recent stress(GARS) 척도와 symptom checklist-90-revised(SCL-90-R)를 사용하였다. 세포성 면역기능은 phytohemagglutinin(PHA)에 대한 임파구 증식반응 및 interleukin-2(IL-2)생성능을 측정하여 평가하였다. 비타민투여군이 비투여군에 비해 SCL-90-R상 불안척도의 점수가 유의하게 낮았다. 그러나 비타민 B 투여유무에 따른 임파구증식반응 및 IL-2생성능은 유의한 차이를 보이지 않았다, 시간경과에 따른 임파구증식반응은 유의하게 증가되었다. 시간 경과 및 비타민 투여유무에 따른 임파구증식반응 및 IL-2생성능의 변화량은 각각 유의한 차이를 보이지 않았다. 결론적으로 비타민 B복합제는 불안을 경감시키나 세포성 면역기능에는 유의한 영향을 미치지 않음을 시사한다. 한편 시험스트레스는 비타민 B 투여에 관계없이 임파구증식반응을 증가시킬 가능성이 시사되었다.

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정신과 교대근무와 주간근무 간호사에서 수면의 주관적 및 활동기록기 평가의 비교 (Comparisons of Subjective and Actigraphic Measurements of Sleep between Shift-working and Daytime Psychiatric Nurses)

  • 곽준;윤보현;전봉희;시영화;송제헌;박수희;김경민;정하란;정유란;박진형
    • 정신신체의학
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    • 제25권2호
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    • pp.166-175
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    • 2017
  • 연구목적 교대근무는 수면장애를 포함한 다양한 건강상의 문제와 연관이 있고 결국에는 삶의 질을 떨어뜨리는 것으로 알려져 있다. 그러나 임상현장에서는 주로 대상자의 주관적인 보고에 의하여 수면을 평가하고 있다. 본 연구는 정신과 교대근무 간호사의 수면을 주관적인 수면평가와 활동기록기를 이용한 수면평가를 통해 주간근무자와 비교해 보고자 하였다. 방 법 교대근무 간호사 23명과 주간근무 간호사 25명을 대상으로 하였다. PSQI를 이용하여 주관적인 수면의 질을 평가하였고 기타 자기보고척도를 이용하여 정신사회적 측면을 평가하였다. 객관적인 수면을 측정하기 위해 활동기록기를 총 7일간 착용하도록 하였고, 그 기간 동안 수면일지를 함께 작성하였다. 교대근무군과 주간근무군간에 활동기록기의 수면변수, PSQI 총점과 구성요소 그리고 자기보고척도로 평가한 결과를 비교하였다. 결 과 PSQI 총점은 양군 간 유의한 차이를 보이지는 않았으나 PSQI 구성요소 중에서 교대근무군이 유의하게 수면의 질(C1)이 나쁘고, 수면장애(C5)와 수면제 사용(C6)이 많으며, 주간기능장애(C7)가 심한 것으로 나타났다. 활동기록기로 측정한 수면변수에서 교대근무군이 주간근무군에 비해 유의하게 잠자리에 누워있는 시간과 총 수면시간이 짧으며, 수면효율이 떨어지고, 평균각성시간이 긴 것으로 나타났다. 결 론 교대근무 간호사가 주간근무 간호사에 비해 주관적 수면평가 및 활동기록기를 통한 객관적 지표 모두에서 수면에 문제를 보이는 것으로 나타났다. 본 연구는 활동기록기가 수면장애를 평가하는데 있어 주관적 설문만으로는 측정이 어려운 객관적 수면변수를 측정하는 데 유용한 도구일 가능성을 시사한다.

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

  • Mohammadi, Shooka;Sulaiman, Suhaina;Koon, Poh Bee;Amani, Reza;Hosseini, Seyed Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7749-7755
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    • 2013
  • Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

Neurocognitive Function Differentiation from the Effect of Psychopathologic Symptoms in the Disability Evaluation of Patients with Mild Traumatic Brain Injury

  • Kim, Jin-Sung;Kim, Oh-Lyong;Koo, Bon-Hoon;Kim, Min-Su;Kim, Soon-Sub;Cheon, Eun-Jin
    • Journal of Korean Neurosurgical Society
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    • 제54권5호
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    • pp.390-398
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    • 2013
  • Objective : We determined whether the relationship between the neuropsychological performance of patients with mild traumatic brain injury (TBI) and their psychopathological characteristics measured by disability evaluation are interrelated. In addition, we assessed which psychopathological variable was most influential on neuropsychological performance via statistical clustering of the same characteristics of mild TBI. Methods : A total of 219 disability evaluation participants with mild brain injury were selected. All participants were classified into three groups, based on their psychopathological characteristics, via a two-step cluster analysis using validity and clinical scales from the Minnesota Multiphasic Personality Inventory (MMPI) and Symptom Checklist-90-revised (SCL-90-R). The Korean Wechsler Adult Intelligence Scale (K-WAIS), Korean Memory Assessment Scale (K-MAS) and the Korean Boston Naming Test (K-BNT) were used to evaluate the neurocognitive functions of mild TBI patients. Results : Over a quarter (26.9%) experienced severe psychopathological symptoms and 43.4% experienced mild or moderate psychopathological symptoms, and all of the mild TBI patients showed a significant relationship between neurocognitive functions and subjective and/or objective psychopathic symptoms, but the degree of this relationship was moderate. Variances of neurocognitive function were explained by neurotic and psychotic symptoms, but the role of these factors were different to each other and participants did not show intelligence and other cognitive domain decrement except for global memory abilities compared to the non-psychopathology group. Conclusion : Certain patients with mild TBI showed psychopathological symptoms, but these were not directly related to cognitive decrement. Psychopathology and cognitive decrement are discrete aspects in patients with mild TBI. Furthermore, the neurotic symptoms of mild TBI patients made positive complements to decrements or impairments of neurocognitive functions, but the psychotic symptoms had a negative effect on neurocognitive functions.

만성 폐쇄성 폐질환의 중증도에 따른 자가관리, 증상경험 및 건강관련 삶의 질 (Self-Care, Symptom Experience, and Health-Related Quality of Life by COPD Severity)

  • 강귀정;김명희;황선경
    • 성인간호학회지
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    • 제20권1호
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    • pp.163-175
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    • 2008
  • Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

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진로지도 자기효능감과 합리적 행동에 대한 실증 사례연구 (An Empirical Case Study on Self-Efficacy of Career Guidance and Theory of Reasoned)

  • 엄명용;최연숙
    • 직업교육연구
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    • 제29권3호
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    • pp.23-40
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    • 2010
  • 본 연구에서는 특성화 공업계 고등학교에서 학교 교육과정 운영 주체인 교사들이 가지고 있는 개인별 특성과, 특성화 공업계 고등학교가 가지고 있는 학교별 특성이 학교 교육과정 편성 운영에 미치는 영향을 알아보기 위한 조사연구이다. 조사대상은 유층 표집한 82개 특성화 공업계 고등학교를 대상으로 실시하였다. 분석 결과, 교사 변인별 특성과 학교별 특성이 교육과정 편성 운영에서 유의미한 차이가 나타났다. 먼저, 교사 변인별 특성은 교육과정 편성에서는 '교육계획수립'과 '교육활동 편성의 적절성'에, 교육과정 운영에서는 '기자재 적절성'에 영향을 미치는 것으로 나타났다. 특히 교사 변인별 특성 중에서 '교사직위'는 이들 변인들에 공통적으로 의미있는 영향력을 나타냈다. 다음으로, 학교별 특성은 교육과정 편성에서는 '학년 교과목간 연계성', '교육활동 편성의 적절성' 및 '교과교육과정의 충실성'에, 교육과정 운영에서는 '특성화 추진의지'에 영향을 미치는 것으로 나타났다. 특히 학교별 특성 중에서 '숙영시설'이 '학년 교과목간 연계성', '교육활동 편성의 적절성'에 공통적으로 의미있는 요인으로 나타났으며, '교육활동 편성의 적절성'에서는 '특성형태'와 '성별'이 미미하지만 의미있는 요인으로 나타났다. 마지막으로, 특성화 공업계 고등학교의 편성 운영 발전방안에서 '직업교육에 대한 사회 전반적인 인식 전환'에 대한 요구가 가장 높게 나타났다.

PubMed 검색(檢索)을 이용한 전립선(前立腺) 질환(疾患)의 침치료(鍼治療)관련 연구(硏究)에 대한 고찰(考察) (The Review on the Prostate Disease-related Studies with Acupuncture Therapy in PubMed)

  • 송호섭
    • 대한약침학회지
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    • 제7권2호
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    • pp.65-73
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    • 2004
  • Objective : This study was to review on the prostate disease-related studies with Acupuncture therapy in renowned medical internet site of PubMed, and to make master plan of the study, especially, on Bee Venom Acupuncture(BVA) of Prostate disease and then to devise the idealistic therapeutic ways of it. Method : We made the internet search with the key words of bee venom(bee venom therapy, apitoxin, apitherapy, bee sting, bee sting therapy), acupuncture, prostate, prostatitis, prostrate cancer in Pubmed, from June 1st to July 1st,2004. Results : 1.25 papers were found in 19 publised jounals. of which two named'Urology'and Prostate' had three papars, two called 'JUrology' and 'Cancer Immunol Immunother' had two papers, and the others had a paper respectively. 2. In the classification by papers' types, Review papers were 8 and Original were 17 where there were 5 clinical trials, 11 experimental studies and 1 epidemiologic paper. Of 5 clinical trials, 2 belonged to Randomized Control Study, and of 11 experimental studies, 4 belonged to in vitro and 7 belonged to in vivo with in viro studies, and 1 epidemeologic belonged to meta-analysis. 3. In the classification by prostate diseases, 4 were about prostatitis, 3 were about prostate related symptoms, 16 were about prostate cancer, and two were about the others. 4. In the classification by applied treatment methods, 5 were related with Acupuncture, 10 were related with BVA(Bee Venom, Bee), and 10 were related with the others. Of 5 related with Acupuncture, 3 used general acupuncture, 1 used electrical acupuncture, and 1 used general acupuncture and electrical acupuncture at the same time. 5. In 2 RCTs of Clinical trials, Control group was set up to the group using different compatible treatment method or using meridians not related with treating prostate disease. Single or double blind methods couldn't be found. 6. In the clinical trials, IPSS, NIH, CPSI or subjective global assessment were used as the Index of Evaluation. 7. The Leg Greater Yang Bladder Meridian(B), The Leg Lesser Um Kidney Meridian(K) and Conception Vessel Meridian(CV) were used as major meridians, and B10(Taejo, Dazhu), B23(Shinsu, Shenshu), B28(Panggwangsu, Pangguangshu), B35(Hoeyang, Huiyang), B39(Wiyang, Weiyang), B40(Wijung, Weizhong), B54(chilbyon, Zhibian), K1(Yongchon, Yongquan), K10(Umgok, Yingu), CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan),S6(Hyopko, Jiache) were used as acupoints. Electrical acupuncture(EA) was considered to be more important and CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan) were mainly selected as EA applied acupoints. 8. It is mostly said that Acupuncture appeared to be a safe, effective, and durable treatment alternative in improving symptoms of patients with prostate diseases, refractory to conventional medicine. A larger controlled study was required to confirm these encouraging initial results. Conclusion : Papers about BVA of Prostate cancer or Prostatitis were not found, and low permeability of Prostate is concerned, BVA with the anti-inflammatory and anti-cancer effect can be adopted as a new alternatives of Prostate disease treatment, so it is thought that Study of how to make access to prostate, animal experiment including in vivo and in vitro and more clinical trials with using acupoints on related meridian should be followed.