• 제목/요약/키워드: Unmet Needs

검색결과 215건 처리시간 0.023초

Behavioral Symptoms in Nursing Home Residents with Dementia: Developing a Nursing Practice Model

  • Kim, Hyo Jeong
    • 성인간호학회지
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    • 제18권3호
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    • pp.488-499
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    • 2006
  • Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

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장기이식 대기자와 수혜자의 불안, 우울 및 삶의 질 비교 (Comparison of Anxiety, Depression, and Quality of Life between Organ Transplant Candidates and Recipients)

  • 차지은;이명선
    • 성인간호학회지
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    • 제24권3호
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    • pp.284-293
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    • 2012
  • Purpose: The aim of this study was to compare the levels of anxiety, depression, and quality of life (QOL) among kidney or liver transplant candidates and recipients. Methods: A cross-sectional descriptive design was utilized. The 160 subjects were recruited and assigned to three different conditions: awaiting transplant group; post-transplantation (TPL) group within less than one year of surgery; and post-TPL group with one year and no more than two years post surgery. The levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. The level of quality of life was measured by the Medical Outcomes Study Short Form-36 version 2. Results: The anxiety score was significantly higher in the waiting group compared with the 1~2 years post TPL group. The depression score was significantly higher in the waiting group compared with the post TPL groups. The QOL was significantly lower in the waiting group compared with the post TPL groups. Conclusion: Our results show a high prevalence of anxiety and depression and a marked reduction in the QOL in transplant candidates compared to the recipients. This study indicates that the group waiting for transplants may have unmet needs during that time period. Health professionals should be encouraged to attend to the psychological distress of the transplant candidates in order to improve their quality of life.

노인의 대사증후군 인지 및 신체활동 실천 요인 (Metabolic Syndrome Perception and Exercise Behaviors in the Elderly)

  • 이정아;이진석;박종헌
    • 보건교육건강증진학회지
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    • 제29권5호
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    • pp.61-75
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    • 2012
  • Objectives: A great number of the elderly are not aware of having metabolic syndrome, and this pattern differs among regions of the nation. This issue is particularly important for the elderly people with chronic diseases. This study was conducted in order to identify the prevalence, predicting factors of perception and exercise behaviors of among the elderly population. Methods: Using data from the 2009 Korean Community Health Survey, we employed two-level logistic regression models to determine whether individual and community factors are associated with perception and exercise behaviors among the elderly population. Results: Results from weighted two-level logistic regression analyses indicated the individual-level factors of smoking, education level, health center education, community exercise program participation and unmet needs in men, and marital status (being separated), health center education women predicted the elders' perception. As for the community-level predictors, higher smoking and living in regions with high suicide rates significantly predicted the elders' perception and exercise behaviors of metabolic syndrome. Conclusions: These findings demonstrate that education according to stage would increase the perception and motivation toward healthier behavior particularly for the elderly with lower perception levels of metabolic syndrome.

장애인 암 검진 수검에 영향을 미치는 요인 (Affecting Factors of Cancer Screening for Persons with Disabilities)

  • 김예순;김선용;남영희
    • 대한통합의학회지
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    • 제7권4호
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    • pp.43-52
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    • 2019
  • Purpose: This study aimed to analyze the affecting factors related to cancer screening for persons with disabilities. Methods: We examined the factors affecting cancer screening in individual aged older than 20 years who participated in the 2017 National Survey of the Disabled. The subjects were 6031 individuals with disabilities who were aged older than 20 years. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression with the SPSS Win 21.0 software. Results: Cancer screening among persons with disabilities is differentiated based on age, education level, marital status, type of disability, grade of disability, subjective house economic status, health insurance, chronic disease, unmet healthcare needs, suicidal thinking, and health screening. The significant predictors of health screening were age, marital status, chronic disease, and health screening. Conclusion: Based on the results of this study, it is necessary to develop a program for young, medical care recipients to improve the participations of disabled in cancer screening.

뮤코다당증의 장기 치료 효과와 한계점 극복을 위한 노력

  • 손영배
    • 대한유전성대사질환학회지
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    • 제14권1호
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    • pp.29-36
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    • 2014
  • Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic diseases caused by deficiency of lysosomal enzymes. MPSs are clinically heterogeneous and characterized by progressive deterioration in visceral, skeletal and neurological functions. The aim of this article is to review the treatment of MPSs, the unmet needs of current treatments and vision for the future including recent clinical trials. Until recently, supportive care was the only option available for the management of MPSs. Hematopoietic stem cell transplantation (HSCT), another potentially curative treatment, is not routinely advocated in clinical practice due to its high risk profile and lack of evidence for efficacy. From the early 2000s, enzyme replacement therapy (ERT) was approved and available for the treatment of MPS I, II and VI. ERT is effective for the treatment of many somatic symptoms, particularly walking ability and respiratory function, and remains the mainstay of MPS treatment. However, no benefit was found in the neurological symptoms because the enzymes do not readily cross the blood-brain barrier (BBB). In recent years, intrathecal (IT) ERT, substrate reduction therapy (SRT) and gene therapy have been rapidly gaining greater recognition as potential therapeutic avenues. Although still under investigation, IT ERT, SRT and gene therapy are promising MPS treatments that may prevent the neurodegeneration not improved by ERT.

Neuroimmunological Mechanism of Pruritus in Atopic Dermatitis Focused on the Role of Serotonin

  • Kim, Kwangmi
    • Biomolecules & Therapeutics
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    • 제20권6호
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    • pp.506-512
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    • 2012
  • Although pruritus is the critical symptom of atopic dermatitis that profoundly affect the patients' quality of life, controlling and management of prurirtus still remains as unmet needs mainly due to the distinctive multifactorial pathogenesis of pruritus in atopic dermatitis. Based on the distinct feature of atopic dermatitis that psychological state of patients substantially influence on the intensity of pruritus, various psychotropic drugs have been used in clinic to relieve pruritus of atopic dermatitis patients. Only several psychotropic drugs were reported to show real antipruritic effects in atopic dermatitis patients including naltrexone, doxepin, trimipramine, bupropion, tandospirone, paroxetine and fluvoxamine. However, the precise mechanisms of antipruritic effect of these psychotropic drugs are still unclear. In human skin, serotonin receptors and serotonin transporter protein are expressed on skin cells such as keratinocytes, melanocytes, dermal fibroblasts, mast cells, T cells, natural killer cells, langerhans cells, and sensory nerve endings. It is noteworthy that serotonergic drugs, as well as serotonin itself, showed immune-modulating effect. Fenfluramine, fluoxetine and 2, 5-dimethoxy-4-iodoamphetamine significantly decreased lymphocyte proliferation. It is still questionable whether these serotonergic drugs exert the immunosuppressive effects via serotonin receptor or serotonin transporter. All these clinical and experimental reports suggest the possibility that antipruritic effects of selective serotonin reuptake inhibitors in atopic dermatitis patients might be at least partly due to their suppressive effect on T cells. Further studies should be conducted to elucidate the precise mechanism of neuroimmunological interaction in pruritus of atopic dermatitis.

노인 암환자의 건강관련 삶의 질 영향요인: 2015년 한국의료패널 자료 분석 (Comparison of Factors Influencing Health-Related Quality of Life between Young-Aged and Old-Aged Patients with Cancer: Analysis of the 2015 Korea Health)

  • 김신미;이인숙
    • 가정∙방문간호학회지
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    • 제27권2호
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    • pp.156-168
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    • 2020
  • Purpose: This study aimed to examine factors influencing health-related quality of life (HRQOL) and compare them between young-aged and old-aged patients with cancer. Methods: Data of 291 patients (young-aged: 168, old-aged: 123) were obtained from the 10th wave of the 2015 Korea Health Panel Survey. The HRQOL was measured using the Korean version of Euro-QoL-5D. Independent t-test, analysis of variance, and multiple regression analysis were performed to identify factors influencing HRQOL. Results: The average HRQOL score was 0.87±0.10 and 0.82±0.15 among young-aged and old-aged, respectively. The factors differed partially between the two groups. For young-aged, the influencing factors were activity restriction, subjectively perceived health status, and smoking. For old-aged, the influencing factors were activity restriction, subjective health status, and unmet healthcare needs. Conclusion: Strategies to improve the HRQOL of elderly adults need to be developed considering the age group. Additionally, studies that include clinical factors such as symptoms are required to prepare need-based practical approaches for better quality of life of such patients.

Tumor Immunology and Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer

  • Jung, Chi Young;Antonia, Scott J.
    • Tuberculosis and Respiratory Diseases
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    • 제81권1호
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    • pp.29-41
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    • 2018
  • Lung cancer is one of the most commonly diagnosed cancers and the leading cause of cancer-related deaths worldwide. Although progress in the treatment of advanced non-small cell lung cancer (NSCLC) has been made over the past decade, the 5-year survival rate in patients with lung cancer remains only 10%-20%. Obviously, new therapeutic options are required for patients with advanced NSCLC and unmet medical needs. Cancer immunotherapy is an evolving treatment modality that uses a patient's own immune systems to fight cancer. Theoretically, cancer immunotherapy can result in long-term cancer remission and may not cause the same side effects as chemotherapy and radiation. Immunooncology has become an important focus of basic research as well as clinical trials for the treatment of NSCLC. Immune checkpoint inhibitors are the most promising approach for cancer immunotherapy and they have become the standard of care for patients with advanced NSCLC. This review summarizes basic tumor immunology and the relevant clinical data on immunotherapeutic approaches, especially immune checkpoint inhibitors in NSCLC.

잠재계층분석을 활용한 결혼이주여성의 건강관련행동 군집유형과 영향요인 (Health related behavior patterns and associated factors among marriage immigrant women using latent class analysis)

  • 조원섭;유승현;김혜경
    • 보건교육건강증진학회지
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    • 제32권5호
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    • pp.17-31
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    • 2015
  • Objectives: This paper aims to identify the health related behaviors patterns and its associated factors among marriage immigrant women in Korea, and discusses their application to health promotion strategies. Methods: The study participants were 7,591 immigrant wives in Gyeonggi province who participated in health examinations conducted by the Korea Association of Health Promotion in 2011-2013. The participants completed self-administered questionnaires on sociodemographics, psychological characteristics, health status and health care factors, and health related behaviors. Results: A 3-latent-class model of health behaviors was identified related to 'lack of physical activity', 'abnormal diet', and 'not experienced medical check-up': 'high risk class', 'middle risk class', and 'low risk class'. Most of the participants belong to 'middle risk class'. Country of origin, age, length of stay, number of children, work status, health insurance status, and unmet health care needs were associated with problematic health behaviors in middle risk health behavior class. Conclusions: Health promotion and intervention programs for marriage immigrant women and their family members need to consider the health behavior patterns of physical inactivity, abnormal diet and no medical check-up and develop multiple behavior intervention with pre-existing program modification.

From Excluded Ghettos to Exclusionary Enclaves: A Private Sector Initiative in Guangzhou, China

  • Chen, Huiwei;Chan, Roger C.K.;He, Qicong
    • 토지주택연구
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    • 제4권3호
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    • pp.211-223
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    • 2013
  • Massive migration is underway in rapidly urbanizing Guangzhou, the south gate of P. R. China. Over half the migrants choose to rent in "villages-in-the-city" in the downtown area because of the low-cost and prime location. The overpopulation and resulting poor environment and high crime-rate turn villages-in-the-city into de facto ghettos. As a result, these ghettos are undergoing a manner of demolition-development, leaving migrants' housing needs unmet. A private-sector initiative-the Tulou Commune-intends to address this considerable market potential. Targeting low-income groups, the Tulou Commune creates a socio-spatially exclusionary enclave. This paper analyzes the Tulou Commune and the implications if more low-income migrants shifting from village-in-the-city (excluded ghetto) to Tulou Commune (exclusionary enclave). This study argues that the intervention of the private sector causes the demographic, social, and spatial similarities and differences of the two living arrangements. Socioeconomic and institutional factors also affect the initiative. This study also provides more empirical evidence in the field of low-cost housing and socio-spatial development in transitional Chinese cities. As the first project of its kind, the analysis of the case can suggest how to improve strategies for accommodating migrants in the future.