• 제목/요약/키워드: Treatment adherence

검색결과 186건 처리시간 0.024초

고혈압-뜸 임상시험 참여자들의 혈압 관리행동에 대한 질적연구 (A Qualitative Study on Management Behaviors about Blood Pressure of Participants in Moxibustion Clinical Trial for Hypertension)

  • 문아지;김태정;이성근;김남권;이기상
    • 대한한방내과학회지
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    • 제33권4호
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    • pp.543-557
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    • 2012
  • Objectives : The purpose of this study which adopted a qualitative method was to evaluate blood pressure management behaviors of pre- and stage 1 hypertension patients and to provide fundamental data for developing a strategy about proper oriental medical treatment through analyzing factors related to a moxibustion clinical trial. Methods : Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 10 hypertensive patients. The interviews lasted for approximately 50 minutes. Results : Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural and they may have side effects. On future management plan of patients, most of them will continue to keep moxibustion and healthy behavior in the well-controlled blood pressure group. However in the uncontrolled blood pressure group, there was an increasing tendency to begin medication. Conclusions : For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

The Kuala Lumpur Qigong Trial for Women in the Cancer Survivorship Phase-Efficacy of a Three-Arm RCT to Improve QOL

  • Loh, Siew Yim;Lee, Shing Yee;Murray, Liam
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8127-8134
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    • 2014
  • Background: Qigong is highly favoured among Asian breast cancer survivors for enhancing health. This study examined the hypothesis that quality of life (QoL) in the Qigong group is better than the placebo (aerobic) or usual care group. Materials and Methods: A total of 197 participants were randomly assigned to either the 8-week Kuala Lumpur Qigong Trial or control groups in 2010-2011. Measurement taken at baseline and post-intervention included QoL, distress and fatigue. Analysis of covariance (ANCOVA) and Kruskal Wallis were used to examine for differences between groups in the measurements. Results: There were 95 consenting participants in this 8week trial. The adherence rates were 63% for Qigong and 65% for the placebo group. The Qigong group showed significant marginal improvement in Quality of life scores compared to placebo (mean difference=7.3 unit; p=0.036), compared to usual care (mean difference=6.7 unit; p=0.048) on Functional Assessment Cancer Therapy-Breast measure. There were no significant changes between the placebo and usual care groups in fatigue or distress at post intervention (8-week). Conclusions: Cancer survivors who participated in the Qigong intervention showed slightly better QOL. Follow up studies are greatly needed to evaluate which subgroups may best benefit from Qigong. With a steep rise of cancer survivors, there is an urgent need to explore and engage more cultural means of physical activity to fight side effects of treatment and for cancer control in developing countries.

자가 진피지방술을 이용한 집게조갑의 교정 (Correction of Pincer Nail using Autogenous Dermofat Graft)

  • 김현성;김철한;강상규;탁민성
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.250-255
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    • 2010
  • Purpose: Pincer nail is a relatively rare deformity characterized by an increase in transverse curvature along the longitudinal axis of the nail. This curvature commonly increases from proximal to distal end of nail, leading to pinching, curling, and distortion of the underlying soft tissue and resulting frequently in severe pain. Numerous surgical procedures have been reported. Preserving the width of the nail in the correction of the pincer nail is very important for functional and aesthetic reasons. We report the results of the correction of the pincer nail using autogenous dermofat graft with a good result. Methods: From May 2006 to September 2008, dermofat graft was performed in 6 patients with pincer nail. Patients were four women and two men, and the average age was 51. The affected digits were the unilateral great toes in four patients and the unilateral thumbs in two patients. Average follow-up period was 13 months. Surgical procedure was removal of nail using an elevator to avoid damage to the nail bed. An incision was created in distal portion of hyponychium. Paronychium was dissected from distal phalanx by periosteal elevator through incision of hyponychium and tunnel was made. Then dermofat grafts harvested from inguinal area were inserted into the tunnel. Finally, a silicone sheet was inserted eponychial fold for prevention of synechia. Objective assessment was evaluated by use of the width index and height index. Results: All patients reported resolution of the pain and soft tissue pinching sensation that they had before the operation. There was good adherence between the nail plate and the underlying nail bed. The nails have regrown and were corrected in a normal and flattened appearance. The width index and height index were improved. Conclusion: The autogenous dermofat graft seems to provide an effective treatment of the pincer nail with preservation of the nail matrix.

근육내 자극요법 후 목빗근내 농양의 치험례 (A Case of Intramuscular Abscess in the Sternocleidomastoid Muscle after Intramuscular Stimulation (IMS))

  • 김재인;최환준;최창용;양형은
    • Archives of Plastic Surgery
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    • 제37권2호
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    • pp.182-186
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    • 2010
  • Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

성별에 따른 혈액투석 환자의 삶의 만족도에 미치는 영향요인 (Factors Affecting the Life Satisfaction of Hemodialysis Patients by Gender)

  • 조윤희;박연숙
    • 한국콘텐츠학회논문지
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    • 제17권8호
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    • pp.631-643
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    • 2017
  • 본 연구는 성별에 따른 혈액투석 환자의 삶의 만족도에 미치는 영향요인을 파악하여 혈액투석 환자의 삶의 질을 향상시키기 위해 시도되었다. 연구 대상은 D광역시, C도에 소재한 혈액 투석실에서 혈액투석치료를 받고 있는 환자로 총 168명이었다. 자료 수집은 2015년 8월 20일부터 2015년 9월 5일까지 실시되었다. 자료 분석은 SAS 9.3 통계프로그램을 이용하여 빈도분석, 카이제곱검정, t-test와 분산분석 및 다중 회귀분석을 시행하였다. 분석결과, 남성은 가족지지(t=5.33, p<.001), 자기효능감(t=3.52 p<.001)이 종속변수인 삶의 질에 대해 통계적으로 유의미한 영향을 미치는 것으로 나타났다. 여성은 가족지지(t=2.58 p=.012), 자가간호이행(t=4.08, p<.001)이 종속변수인 삶의 질에 대해 통계적으로 유의미한 영향을 미치는 것으로 나타났다. 본 연구 결과를 바탕으로 혈액투석 환자를 돌보는 간호사는 혈액투석 환자의 성별에 따른 삶의 만족도에 미치는 영향요인을 인식하여 간호중재를 개발하고 활용함으로써 혈액투석 환자의 정서적, 심리적 안정을 증진시킬 수 있을 것으로 사료된다.

Knowledge about Gastric Carcinoma in North of Iran, A High Prevalent Region for Gastric Carcinoma: A Population-Based Telephone Survey

  • Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Soati, Fatemeh;Mansour-Ghanaei, Alireza;Naserani, Sara Bakhshizadeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3361-3366
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    • 2012
  • Background & Objectives: The most northern and northwestern regions of Iran are at a high risk for gastric cancer. The aim of this study was to assess the general population's awareness about risk factors, symptoms and signs, preventive methods and management of gastric carcinoma in a high prevalence city in the North of Iran. Methods: A cross-sectional population-based telephone survey which was conducted on 3,457 residents of Rasht, the capital city of Guilan Province, to assess their awareness regarding gastric carcinoma. The questionnaires contained demographic data and statements on respondents' knowledge about risk factors, symptoms and signs, prevention and management of gastric cancer which were filled by general practitioners after asking the subjects. Data were analyzed in SPSS14. P<0.05 was considered significant. Results: The mean knowledge score of the respondents was $5.05{\pm}1.37$ regarding risk factors of gastric carcinoma, $4.39{\pm}1.99$ regarding symptoms and signs, $6.0{\pm}1.22$ regarding preventive strategies, and $1.6{\pm}1.16$ regarding management. Totally the mean knowledge level of the respondents toward gastric carcinoma would be $17.1{\pm}3.97$ from the maximum grade of 29. The age group of 45-55 y/o, bachelor degree and higher, physicians and nurses, those who had cancer history in friends or had the history of gastrointestinal diseases showed significantly higher knowledge scores (P=0.001). Conclusion: There is a general lack of awareness of cancer risk factors, symptoms and signs, methods of prevention, and importance of early diagnosis and treatment. Educational programs should be developed to promote adherence to recommended screening guidelines.

Self-checking Type, Repetitive, Education Efficacy for Temporomandibular Disorder Patients

  • Ok, Soo-Min;Kim, Kyung-Hee;Heo, Jun-Young;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • 제40권2호
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    • pp.72-78
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    • 2015
  • Purpose: The purpose of this research was twofold: to compare the short-term efficacy of once-off education versus repetitive education (RE) of patients suffering from temporomandibular disorders (TMDs) and to determine whether there was any correlation amongst patient demographics, recommendation adherence degree and pain levels. Methods: A total of 848 patients with TMDs were enrolled. The control group consisted of patients who received a standard conservative treatment (STD) over at least 6 visits with education provided only during the first visit. The experimental group consisted of patients who received STD but had also been given RE (STD+RE). The RE was delivered through a standardized self-assessment questionnaire (SAQ) that was completed by the patient during each visit. Pain, which included maximum comfortable opening (MCO) of the mouth and limitation of mouth opening (LOM), was compared between the two groups. Behavior pattern and reported pain level changes in the group who used the SAQ were also analyzed. Results: The LOM was significantly improved in all of the experimental group patients (especially in females under 30 years of age, p<0.05). The MCO was significantly higher in females (p=0.029). All of the patients displayed improvements in their habits following RE, which resulted in a strong correlation with pain reduction. Adhering to the recommendations regarding questions 14 and 15 of the SAQ appeared to have the greatest effect on pain reduction. Conclusions: These results clearly demonstrate that RE is more effective than once-off education for TMD patients who are female or under 30 years of age.

관절염 자조관리 및 수중운동 프로그램 운영에 대한 평가 연구 (Needs of Instructors for Developing Self-Help and Aquatic Exercise Programs of Korean Rheumatology Health Professionals Society)

  • 이은옥;서문자;김금순;강현숙;임난영;김종임;송경애;한상숙;이경숙;이인옥
    • 근관절건강학회지
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    • 제8권2호
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    • pp.217-229
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    • 2001
  • The purpose of this study is to analyze the needs of instructors for developing self-help and aquatic exercise programs of Korean Rheumatology Health Professionals Society (KRHPS). Data were collected by self-administered questionnaires via mail for 63 out of 248 certified instructors from KRHPS. Authors analyzed the data based upon following 3 criteria, 1) demographical data of the instructors, 2) content of the programs, 3) evaluation of arthritis self-help and aquatic exercise program. As a result, most of respondents satisfied with the two programs in general, but they need some modification of the program in partly. They need more information about practical method of exercise, complementary theray, and treatment of arthritis. Also they proposed developing more interesting exercise program which can be learn with ease and enjoyable. It is also suggested that developing new exercise program would be needed to improve adherence of exercise.

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인체단핵세포주 THP-1세포에서 Human Cytomegalovirus의 잠복감염과 재활성화 (Latent Infection and Reactivation of Human Cytomegalovirus from Human Monocyte THP-1 Cells)

  • 윤상임;문명숙;이찬희
    • 미생물학회지
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    • 제37권2호
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    • pp.145-150
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    • 2001
  • Human cytomegalovirus (HCMV)의 잠복감염으로 부터의 재활성환느 면역기능이 저하된 사람에게 높은 치사율을 가져오며, 재활성화가 기전의 규명은 매우 중요한 연구과제의 하나이다. HCMV의 잠복감염 부위 중 하나라고 생각되고 있는 인체단핵세포에 대한 HCMV의 영향을 알아보기 위해 여러 분화 단계에 있는 THP-1과 HL-60 세포에 HCMV를 감염시킨 후 생존 세포의 수와 형태적 변화를 살펴보았다. HL-60 세포가 HCMV 감염에 의해 세포 생존이나 형태에 큰 영향을 받지 않는 반면, 좀 더 분화된 세포인 THP-1은 HCMV 감염에 의해 생존 세포의 수가 감소하였고, 형태적 변화도 나타났다. 이러한 형태적 변화는 세포의 응집력의 증가에 의한 것으로 HCMV 감염에 따른 THP-1 세포 표면의 CD11b 발현 증가와 밀접한 관계가 있는 것으로 생각된다. THP-1 세포에 HCMV를 감염시킨 후 잠복감염이 이루어진 것을 확인하고, 세포 분화 유도제인 TPA와 hydrocortisone을 처리하였을 경우 방러스가 재활성화하여 증식하는지 알아보았다. 바이러스 감염 2일째에 분화시킨 THP-1 세포에서는 분화 5일째부터 다량의 바이러스가 검출되었고, 감염 17일째 분화시킨 세포에서는 분화 후 15일째부터 바이러스가 검출됨을 관찰하였다. 이는 HCMV를 THP-1 세포에 감염 후 분화를 시키면 잠복감염해 있는 HCMV가 재활성화 되는 것이라 생각되고, 감복해 있던 기간이 길어질수록 바이러스의 재활성화정도는 지연된다는 것을 의미한다.

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캔디다균 감염 마우스 모델에서 병독인자의 비교위험도 (Relative Risk of Virulence Factors in Candida-Infected Mouse)

  • 김동화;신운섭;이경호;김경훈;박윤선;박주영;고춘명
    • 대한미생물학회지
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    • 제35권4호
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    • pp.317-324
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    • 2000
  • Candida albicans is one of the most frequently isolated fungal pathogens in human. Recently, the prevalence of candida infection has markedly increased, partially due to the increase of immunocompromised hosts. Proposed virulence factors of the pathogenic Candida are the ability to form hyphae to adhere to epithelial cell surfaces, and to secrete acid proteinases and phospholipases. We measured the relative cell surface hydrophobicity (CSH) and the ability of proteinase production (PROT), phospholipase production (PLase), adherence to host epithelium (ADH), and hyphal transition (Germ). The relative risk of virulence factors was analyzed by lethality test in murine model of hematogeneously disseminated candidal infection. According to Cox's proportional hazard analysis, the statistically significant virulence factors were PROT, ADH, and CSH. PROT was the highest risk factor of them. To evaluate the applicability for the diagnosis and treatment of Candidiasis, we examined the protective effect of the active and passive immunizations with the materials purified from virulence factors and antibodies to them in Candia-infected mice model. The mean survival times of active and passive immunized groups were slightly longer than those of non-immunized groups.

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