• Title/Summary/Keyword: Symptom severity

검색결과 485건 처리시간 0.024초

Testing the Mediating Effect of Appraisal in the Model of Uncertainty in Illness

  • Kang, Younhee
    • 대한간호학회지
    • /
    • 제33권8호
    • /
    • pp.1127-1134
    • /
    • 2003
  • Background. Although there have been a great number of research studies based on the model of uncertainty in illness, few studies have considered the appraisal portion of model. Purpose. The purpose of this study was to test the mediating effect of appraisal in the model of uncertainty in illness. Additionally, this study aimed to examine the relationships among uncertainty, symptom severity, appraisal, and anxiety in patients newly diagnosed with atrial fibrillation. Methods. This study employed a descriptive correlational and cross-sectional survey design using a face-to-face interview method. Patients diagnosed with atrial fibrillation within the previous 6 months prior to data collection were interviewed by Mishel Uncertainty in Illness Scale-Community Form, appraisal scale, Symptom Checklist-Severity V.3, and State Anxiety Inventory. Results. A total of 81 patients with atrial fibrillation were recruited from two large urban medical centers in Cleveland, Ohio, U.S.A.. Symptom severity was the significant variable in explaining uncertainty ($\beta$=0.34). Individuals with greater symptom severity perceived more uncertainty. Uncertainty was appraised as a danger rather than opportunity, and those with greater uncertainty appraised a greater danger (p<.0l). While the appraisal of opportunity had the negative relationship with anxiety (r=-0.25), the appraisal of danger was positively associated with anxiety (r=0.78). The measure of goodness of fit (Q) of the model was .7863, and the significant test (X$^2$) for the Q was statistically significant (df =3, p<.00l). Accordingly, the overall mediating model of uncertainty in illness was proven not to be fit to the empirical data of patients with atrial fibrillation. Consequently, the mediating effect of appraisal was not supported by the empirical data of this study. Conclusion. The findings of this study were discussed in terms of their relevance compared with those of previous studies or theoretical framework and the plausible explanations on study findings. Lastly, in order to expand the present body of knowledge on uncertainty in illness model, recommendations for the future nursing studies were included.

고용량 방사성요오드($I^{131}$)치료를 받는 갑상선암 환자의 우울, 불안이 증상에 미치는 영향 (Effect of Depression and Anxiety on Symptoms in Thyroid Cancer Patients Undergoing Radioactive Iodine($I^{131}$) Therapy)

  • 전나미
    • 종양간호연구
    • /
    • 제12권4호
    • /
    • pp.297-304
    • /
    • 2012
  • Purpose: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. Methods: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine ($I^{131}$) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. Results: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. Conclusion: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.

아토피 피부염의 평가방법에 대한 연구 : 비교 분석 및 설립 (A study on the Severity Scoring Systems of Atopic Dermatitis ; Comparision, Analysis and Establishment)

  • 윤화정;윤정원;윤소원;고우신
    • 대한한의학회지
    • /
    • 제23권4호
    • /
    • pp.15-26
    • /
    • 2002
  • There is much confusion in the field of atopic dermatitis (AD) regarding how to best measuredisease severity objectively. Therefore, we aimed to establish a new adequate scoring system for AD, that should be based on comparisonand analysis of various scoring systems. We report as follows. Methods: We searched for data relating to severity scoring systems for atopic dermatitis in Entrez PubMed From 1990 to 2001 Results and Conclusions: 1. Properties of severity scoring systems were validity, reliability, sensitivity of change and ease of use. 2. The essential items of severity scoring systems were extent. intensity and subjective symptoms. 3. The surface extent of the lesion was evaluated by the percentage of involvement of each of 10 areas. 4. The criteria of severity were divided into intensity and subjective symptoms. Intensity items are erythema, papulation, lichenification, oozing, dryness, excoriations, and pigmentation. The subjective symptom is pruritus, evaluated according to sleep loss. 5. The significant items of severity scoring system were symptomsrather than areas. As it were, we assumed extent accounted for around 30% of each total score, with intensity and subjective symptoms representing 70%.

  • PDF

Symptom Experiences and Coping Strategies among Multi-ethnic Solid Tumor Patients Undergoing Chemotherapy in Malaysia

  • Yahaya, Nor Aziyan;Subramanian, Pathmawathi;Bustam, Anita Zarina;Taib, Nur Aishah
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제16권2호
    • /
    • pp.723-730
    • /
    • 2015
  • Background: This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies. Results: Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased. Conclusions: These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psychooncology services provided are to be recommended.

아토피 피부염에 대한 임상적 연구 (A Clinical Study on Atopic Dermatitis)

  • 남봉수;조재훈;김윤범;채병윤
    • 대한한의학회지
    • /
    • 제21권4호
    • /
    • pp.204-215
    • /
    • 2000
  • Objectives: This study was conducted to establish the study form of atopic dermatitis in oriental medicine, to find out the effect of herbal medicine and to compare Bangpungtongsungsan group with symptom-complexes prescription group. Methods: We gave scores(1-3) to the 37 outpatients who visited the dept. of Ophthalmotolaryngology & Dermatosurgery of the Kyunghee Oriental Medical Center from June 1,2000 to September 30, 2000. According to transformed the G. Rajka, T. Langeland and Jon M. Hanifin standard. We checked the Eosinophil count, IgE and the scores (intensity: the degree of itching, course: the degree of itching during a year, extent: erythema, lichenification, scaling. dryness, erosion' oozing). After herbal treatment for 6 weeks, we checked the above factors again in the same way. In treatment, we divided the patients into Bangpungtongsungsan group and Symptom-complexes group for cross-comparison. Results: There were 19 patients we could check by score and 14 patients by laboratory. 1. In the 14 lab cases, the number of abnormal value of Eosinophil count and IgE was decreased but it was not significant. 2. In the 19 cases by score, clinical severity of the intensity of itching, lichenification, scaling' dryness was significantly decreased between the before- and after-herbal treatment periods (P<0.01, P<0.01, P<0.05). 3. In 19 cases, clinical severity of erythema, erosion. oozing was decreased after herbal treatment but it was not significant(p>0.05). 4. In point of total score, clinical severity of atopic dermatitis was significantly decreased after herbal treatment(p<0.01). 5. There was no significant difference between Bangpungtongsungsan group and Symptom-complexes group(P<0.05). Conclusions: Although more study is needed, these results indicate that herbal treatment is effective on atopic dermatitis.

  • PDF

An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine

  • Hafize Altay;Seyda Toprak Celenay
    • The Korean Journal of Pain
    • /
    • 제36권1호
    • /
    • pp.137-246
    • /
    • 2023
  • Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

신체 증상 장애 환자의 심박변이도와 증상 심각도의 연관성 (Associations Between Heart Rate Variability and Symptom Severity in Patients With Somatic Symptom Disorder)

  • 김은환;김희선;함진실;김준범;오주영
    • 정신신체의학
    • /
    • 제31권2호
    • /
    • pp.108-117
    • /
    • 2023
  • 연구목적 신체 증상 장애(Somatic Symptom Disorder, SSD)는 다양한 신체 증상의 발현을 특징으로 하며, 현재까지 환자군 내에서 증상 심각도에 따른 자율신경계 활성의 차이에 대해서는 연구된 바가 거의 없다. 이에 본 연구에서는 신체 증상 장애 환자군에서 심박변이도(Heart Rate Variability, HRV) 차이를 검정하여 증상 심각도에 따른 자율신경계 변화를 반영하는 대표적 지표를 분석하였다. 방 법 2020년 9월 18일부터 2021년 10월 29일까지 강남세브란스병원 정신건강의학과에 내원했던 환자 중, DSM-5 진단 기준에 따라 SSD로 진단받은 환자 총 51명의 의무기록을 후향적으로 수집하였다. 이후, 집단 간 인구사회학 및 임상적 선택편의 보정을 위해 역확률 가중치(Inverse Probability Treatment Weighting, IPTW)를 적용하여 HRV 지표 차이 검정을 실시하였다. 결 과 신체 증상 심각도와 LF (nu), HF (nu), LF/HF, 그리고 SD1/SD2, Alpha1/Alpha2는 통계적으로 유의한 상관관계를 보였으며, IPTW 적용 후 비중증군은 27명(53.0%), 중증군은 24명(47.0%)로 보정되었고, 인구사회학적 요인 및 임상적 특성 차이가 유의미하지 않아 동질성이 확보되었다. 본 모형 분석 결과 고위험군일수록 시간 영역의 RMSSD (β=-0.70, p=0.003), pNN20 (β=-1.04, p=0.019), 주파수 영역은 LF (nu) (β=0.29, p<0.001), HF (nu) (β=-0.29, p<0.001), LF/HF (β=1.41, p=0.001), 그리고 비선형 영역에서는 SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), Alpha1/Alpha2 (β=0.43, p=0.001)에서 유의미한 차이가 검정되었다. 결 론 신체 증상 심각도에 따른 HRV 지표의 차이는 시간과 주파수 영역, 그리고 비선형 영역 전반에서 검정되었으며, 신체 증상이 심할수록 교감신경의 과활성화 및 부교감신경의 저하를 시사하는 HRV 지표들이 유의미하게 높은 경향성을 보였다.

일 대학병원 외래 내원 사회공포증 환자에서 증상적 특성의 남녀차이 (Gender Differences in the Symptomatic Characteristics of Social Phobia Patients in One University Hospital)

  • 최홍민;김나현;임세원;오강섭
    • 대한불안의학회지
    • /
    • 제4권1호
    • /
    • pp.62-67
    • /
    • 2008
  • Objectives : Gender differences in demographic characteristics, symptom presentation, and severity may influence the selection of target behaviors as well as the course and outcome of therapeutic interventions for patients with social phobia. The purpose of this study was to explore the gender differences in the symptomatic characteristics of Korean patients with social phobia. Methods : A total of 256 outpatients with social phobia at Kangbuk Samsung Hospital were included in this study. All subjects were evaluated using the Korean version of the MINI International Neuropsychiatric Interview Plus. Potential differences in demographic characteristics, severity of anxiety, and situational fear and avoidance were examined. Self-report questionnaires and interviewer-administered instruments, including the Social Phobia Scale (SPS), Social Phobia subscale of the Fear Questionnaire (FQ-social), Appraisal of Social Concerns (ASC), and Liebowitz Social Anxiety Scale (LSAS), were used to evaluate the severity of the patients' symptoms. Results : There were no gender differences in demographic characteristics, age, age at onset of social phobia, total SPS score, FQ-Social score, ASC score, and LSAS score. In addition, there was no gender difference in the severity of fear in specific social situations. However, women reported significantly higher total scores on the social helplessness category of the ASC than men (p=0.009). Conclusion : Previous studies reported that the severity of social phobia symptoms is greater in women than in men, but our results suggest that there are no significant gender differences in the severity of social phobia symptoms. Thus, gender differences among patients with social phobia are discussed in the context of traditional sex-role expectations.

  • PDF

강박장애 환자에서의 성격 5요인 모델 분석 (Analysis of the Five-Factor Model of Personality in Obsessive-Compulsive Disorder)

  • 허민정;변민수;김성년;김의태;장준환;권준수
    • 대한불안의학회지
    • /
    • 제8권2호
    • /
    • pp.99-105
    • /
    • 2012
  • Objective : The aim of this study is to evaluate the five-factor model of personality in patients with obsessive-compulsive disorder (OCD) related to obsessive-compulsive symptom severity and the distinct symptom subgroups. Methods : We recruited 95 patients with OCD and 116 normal controls in the study. We used the short version of Revised NEO Personality Inventory and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the assessment. Results : Patients with OCD showed significantly higher scores in neuroticism than normal controls. On multiple linear regression analysis, we found that agreeableness and conscientiousness were associated with the total Y-BOCS scores. On subscale analysis, agreeableness and neuroticism were associated with the obsession subscale scores and only conscientiousness was associated with the compulsion subscale scores. Furthermore, we found that patients who have contamination/cleaning or symmetry/ordering/counting/arranging as a main symptom presentation had significantly higher mean scores in conscientiousness than patients who have harm due to injury/violence/aggression as a main symptom presentation. Conclusion : In this study, we found that specific personality factors are associated with the obsessive-compulsive symptom severity. In addition, this is the first study to investigate the relationship between the personality factors in the five-factor model and the distinct symptom subgroups in OCD.

Pyrethroid 중독에 대한 고찰 - 2005년도 농약 중독 실태조사를 기반으로 (The Study of Pyrethroid Intoxication: The basis of Agrichemical Intoxication Survey in 2005)

  • 김아진;김경환;박준석;어은경;오범진;이미진;이성우;서주현;노형근
    • 대한임상독성학회지
    • /
    • 제5권2호
    • /
    • pp.99-105
    • /
    • 2007
  • Purpose: Pyrethroid is an insecticide that produces moderate intoxication in mammals, with neither exposure to skin nor inhalation resulting in severe systemic manifestations. In 2005 we made a nationwide survey of agrichemical human intoxication. The object of this study is to analyze pyrethroid intoxications based on the 2005 survey. Methods: We prospectively collected data from 1 August 2005 to 31 July 2006 by a standard investigation protocol. We analyzed demographic data, exposure data (cause, amount, ingredients), clinical features, and courses. Results: A total of 125 cases of pyrethroid intoxication were surveyed. The mean patient age was $56.78{\pm}16.158$ years old, and the mean amount ingested was $121.85{\pm}110.732ml$. Patients were classified into four severity groups according to symptoms and mental status: the asymptomatic group (27 patients, 21.6%), the mild symptom group (48, 38.4%), the moderate symptom group (21, 16.8%), and the severe symptom group (7, 5.6%). There were statistically significant differences in mental status, severity, and mean ICU days between two groups. Admission days by severity grade for the asymptomatic, mild, moderate, and severe symptom groups were $5.49{\pm}16.051,\;3.65{\pm}4.143,\;4.59{\pm}3.335,\;and\;8.14{\pm}7.199days$, respectively (p=0.047). Conclusion: Nationwide surveillance was extremely telling in uncovering a high frequency of agrichemical intoxication in Korea. In pyrethroid intoxication, severity grading can be a useful prognostic tool.

  • PDF