• Research in Community and Public Health Nursing
• /
• v.14 no.1
• /
• pp.106-119
• /
• 2003

This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

• Quality Improvement in Health Care
• /
• v.5 no.1
• /
• pp.128-138
• /
• 1998

Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.3 s.58
• /
• pp.643-664
• /
• 1997

This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

• Clinical and Experimental Pediatrics
• /
• v.48 no.9
• /
• pp.991-997
• /
• 2005

Purpose : Cow's milk protein-induced enterocolitis(CMPIE) is a symptom complex of vomiting and/or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. Methods : We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. Results : CMPIE was diagnosed in 11 patients(12.8%). On admission, failure to gain weight(P=0.003), hypoalbuminemia(P=0.003), peripheral leukocytosis(P=0.015), and metabolic acidosis(P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight <10 g/day(OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia <3.5 g/dL(OR, 9.18[95% CI, 1.69-49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting(81.8%), abnormal stool test(80.0%), peripheral leukocyte count and absolute neutrophil count(ANC) increase(100.0%) (P<0.05), and enteropathy(100.0%). Conclusion : CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow : failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.2
• /
• pp.170-181
• /
• 1996

Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

• Journal of Hospice and Palliative Care
• /
• v.4 no.2
• /
• pp.137-144
• /
• 2001

Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.1
• /
• pp.37-47
• /
• 2002

Objective : Previous studies have suggested an association between sleep-related breathing disorder (SRBD) and several psychological problems, and there were increasing recognition of the link. The purpose of this study is to evaluate the characteristic profiles of MMPI and SCL-90-R in patients with SRBD. Methods : This study consisted of 80 SRBD patients(73 men, 7 women) referred from Sleep Disorder Clinic of Dong-A University Hospital, Busan, Korea. Basic informations including demographic findings and physical examination were collected. Subjects completed the Epworth Sleepiness Scale(ESS), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revision (SCL-90-R) prior to standard overnight polysomnography that was performed at hospital sleep laboratory. SRBD was divided into two groups of primary snoring(PS) and obstructive sleep apnea(OSA) according to polysomnographic findings. Results : SRBD showed significant elevation rate of Hs, D, and Hy scales of MMPI and SOM scale of SCL-90-R, which exceeded the rate expected in normal individuals(>5%, 2SD). On comparison of clinical scales of SCL-90-R, OSA group had significantly greater mean score than that of PS group in terms of O-C, DEP, PAR, GSI(p<0.05), SOM and PST(p<0.01). OSA group also showed significantly higher elevation rate in Hs scale of MMPI and SOM scale of SCL-90-R than that of PS. Among OSA group, three scales of MMPI(D, Pt, Si) and three scales of SCL-90-R(ANX, PAR, PSDI) had significant correlation with some PSG variables including total sleep time and sleep efficiency. Among PS group, two scales of MMPI(Hy and Pt), elevation rate of MMPI scales and three scales of SCL-90-R(I-S, PAR, PSDI) had significant correlation with some PSG variables including sleep efficiency, sleep latency and REM sleep percent. Conclusion : The above results suggest that SRBD show neurotic profiles in MMPI and SCL-90-R. This study also clearly indicates that PS group are suffered from clinically meaningful psychiatric symptoms, which are quantitatively lessened but qualitatively similar as compared to that of OSA group.

• Research in Community and Public Health Nursing
• /
• v.12 no.2
• /
• pp.397-405
• /
• 2001

The vision disturbances of school- age children has been recognized as and important school health problem. As the visual disturbances of the school-age children is recognized as the nation's health problem. the importance of the development of educational program for visual health should be emphasized. Recently, eyeball movement and other visual health management method has been introduced for prevention or recovery of decrease in visual acuity. But, the effect of eyeball movement was not confirmed yet. And, the controversy around the treatment effect is continued. The decrease of visual acuity is one of the important school health problem as well as it causes discomfort in daily life of the students. So, it should be considered as an important subject for school health and there is a need to develop an effective intervention program for visual health. The purpose of this study is to develop and evaluate the program with the recognition of the need of the intervention for visual health. The visual health promotion program was developed by the researcher and the program was initiated by the school. Nonequivalent control group pretest-posttest design was applied for study which examined the effect of the visual health promotion program. The subjects were 742 children (experimental group: 398; control group: 344). The experiment was composed of health education and eyeball movement. Health education was provided 5 times to the children in the class room. Children of experimental group exercised eyeball movement in the class, watching video for 10 minutes two times a day. The exercise was continued for 10 weeks. The result of the study were as follows. 1) change of visual acuity Before the intervention, mean of the visual acuity was .86 for the experimental group and .91 for control group. After the intervention, mean of visual acuity was .95 for the experimental group and. 90 for the control group. There was no significant difference in the change of visual acuity between experimental and control group. 2) change of refraction. In the experimental group, 327 eyes (41.08%) were normal vision and 469 eyes (58.98%) were eyes of refraction errors, 38.82 % of the total eyes were myopia. There was no significant change in the refraction in the children with myopia after the intervention. 3) Awareness of visual acuity, change of knowledge, behavior. and attitude (1) After the intervention, there was a significant difference in the awareness of visual acuity (experimental group: 70.10%. control group: 50.97%, p<.01). (2) After the intervention, there was a significant knowledge increase in the experimental group (pp<.01). (3) There was no significant difference in the visual health behavior after the intervention. (4) There was a significant positive change in the attitude related to visual health in the experimental group ( pp<.05). 4) There was a significant positive change in the subjective discomfort of the students. But, there was no significant change in the objective eye symptom after the intervention. Even though there was no effect in the visual acuity and the change of the refraction. subjective visual health as well as the attitude and knowledge' of the children and parents toward visual health was improved significantly. Also, there was an increase in the intention of change and the awareness for the visual health management. It is suggested that various educational strategies for visual health promotion should be developed and examined for the visual health promotion of the students.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.34 no.2
• /
• pp.202-208
• /
• 2005

This study was conducted to examine the food habits, knowledge of nutrition and actual conditions of food ingestion of adolescent middle school students according to questionnaire answers. Questionnaires were completed by 524 students, divided into a healthy group (n=289) and an unhealthy group (n=235) according to clinical signs. Further questions were asked of the two groups in the areas of food habits, knowledge of nutrition and nutritional attitude. The results were as follows: Mean age of all subjects was 14, heights for male and female students were 162.0 em, and 157.2 cm, weights were 53.4 kg, and 49.4, respectively. Heights and weights of male students were greater than those of female students. The body mass index (BMI) for male and female students was 20.3 kg/$m^2$ and 20.0 kg/$m^2$, respectively, and all data were within normal ranges. There were no significant differences in mean age, height, weight, and BMI between the healthy and unhealthy groups. There was no significant difference in body image recognition between the two groups, although the ratio of dissatisfaction with their own body shape was significantly higher in the female unhealthy group (46.1%), than in the female healthy group (33.0%) (p<0.05). In the area of the struggle to control body weight during the previous year, the female unhealthy group (59.4%) was higher than the female healthy group (38.4%) (p<0.01). There was no significant difference in the scores between the two groups in the areas of knowledge of nutrition and the nutritional attitude. Meal frequency and meal patterns were showed that having breakfast less than 4x/week was significantly higher in the female unhealthy group (44.0%), than in the female healthy group (30.7%) (p<0.01). Meal frequency for suppers<4x/week showed that the female unhealthy group (18.8%) was also higher than the female healthy group (10.7%). Therefore, the unhealthy group exhibited a higher pattern of missing both breakfast and supper. The male unhealthy group (16.7%) dined out more frequently than the male healthy group (12.3%) (p<0.01), and female unhealthy group also indulged in snacking significantly more frequently than the female healthy group. The unhealthy group also ate only 1 item for meals more frequently than the healthy group and no significant difference. The conclusion of this study is that adolescent Korean middle school students, who showed a higher incidence of clinical symptoms, representing an unhealthy status, missed breakfast and supper, and dined out and indulged in snacking more frequently. Their quality of breakfast and satisfaction of body image were also lower than the healthy group. These results indicated that there is a high correlation between a Korean adolescent's health status, food habits and body image satisfaction. It is recommended that a more intense program of nutritional education and monitoring be introduce into the current Korean middle-school system in order to optimally support and maximize the health potential of the current population of Korean student.