• Title/Summary/Keyword: Weakness and fatigue

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A study on knowledge, self-efficacy and compliance in Reumatic arthritis Patients (류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구)

  • Kim, Soon-Bong
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.238-252
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    • 1998
  • Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

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Hypersensitive Large Intestine Syndrome in Hyungsang Medicine (과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로-)

  • Choi Byung-Tae;Choi Yung-Hyun;Han Jin-Soo;Lee Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Weight Reduction Dieting Survey and Satisfaction Degree and Diet Related Knowledge among Adult Women by Age (연령별 성인 여성의 체중감량 다이어트 실태와 만족도 및 관련지식)

  • Kim, Myung-Kyung;Lee, Gui-Chu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.5
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    • pp.572-582
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    • 2006
  • This survey was conducted from June 2004 to August 2004, through questionnaires given to 432 women aged ranging from 20 to 50 years, who were living in the Seoul metropolitan area. The questionnaires were designed to determine the physique, level of obesity and dieting survey as well as to uncover which diets were in fashion and their satisfaction degree. Dieting-related knowledge and dieting side effects were also investigated. The results were as follows: In dieting survey, as the age increased, dieting for health reason (52.3%) increased, whereas that for aesthetic reasons (32.6%) decreased (p<0.05). The most effective methods of dieting were exercise (50.2%) and diet (45.0%) regimens. In regards to exercise frequency, 46.5% for none, 23.5% for 1-2 times a week, suggesting that most respondents do not practice exercise for dieting purposes (p<0.05). Major source for dieting was shown to be obtained from relative family or friends (31.7%), newspapers or magazines (29.3%) and internet (14.9%). As the age decreased, information from the latter increased, whereas that from TV program (21.2%) decreased (p<0.05). Reasons for excess weight were bad eating habits (39.6%), lack of exercise (38.3%), pregnancy and childbirth (10.6%). In fad dieting, while organic foods and aerobic exercises scored the highest satisfaction degree among diet and exercise regimens, on the other hand, sauna, steam baths and high temperature half-immersion baths scored the highest among surgery and other special therapies. As the age increased, the satisfaction degree for organic foods such as organic vegetable and high functional boiled cooked rice increased (p<0.05). As the age increased, scores on dieting-related knowledge decreased. Side effects of dieting included dizziness 06.2%) fatigue (15.1%) indigestion/constipation (11.1%) physical weakness 00.5%), loss of concentration (7.8%), dry skin (7.4%) loss of motivation (6.7%). The above results showed that attitude toward dieting among adult women varied with age and in light of the well-being trend, organic foods and aerobic exercises scored the highest satisfaction degree through all age.

The Significance of Acetylcholine Receptor Autoantibody Test (아세틸콜린 수용체 항체(Acetylcholine receptor autoantibody) 검사의 의의)

  • Yoo, Soh-Yeon;Lim, Soo-Yeon;Pack, Song-Ran;Seo, Mi-Hye;Moon, Hyung-Ho;You, Sun-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.113-116
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    • 2011
  • Purpose: Acetylcholine receptor antibodies cause acetylcholine receptor loss, which is responsible for failure of the neuromuscular junction in the acetylcholine receptor autoantibody. The disease characterized by muscle weakness and fatigue, myasthenia gravis(MG) occurs when the body inappropriately produces antibodies against acetylcholine receptors, and thus inhibits proper acetylcholine signal transmission. And this reason, the measurement of acetylcholine receptor antibodies can be of considerable value in disease diagnosis. Methods: From 2010. August to September, we tested orderd AchRAb 19 samples to get the results. 1. Pipette $5{\mu}{\ell}$ undiluted patient sera and kit control and add 125I AChR $50{\mu}{\ell}$ and incubate at R.T for 2 hours. 2. Pipette $50{\mu}{\ell}$ of anti-human IgG into each tube, and incubate at $2{\sim}8^{\circ}C$ for 2 hours. 3. Pipette $25{\mu}{\ell}$ precipitation enhancer into each tube and add 1mL washing solution into all tubes. 4. Centrifuge each tube for 20minutes at $2{\sim}8^{\circ}C$ at 1500g. 5. Aspirate or decant the supernatant. 6. Pipette 1 mL washing solution into all tubes and resuspend the pellet and repeat centrifugation. 7. Aspirate or decant the supernatant and count all tubes on a gamma counter. Results: Cut off value is 0.2 nmol/L and the results taken below 0.2 nmol/L are negative, the results above that identified as being positive values. We assayed the 19 patients samples and got 7 positive results. Of which, 6 patients were diagnosed as MG.(85.7%). Conclusions: Acetylcholine Receptor autoantibody test is intended for use by persons only for the quantitative determination of it in human serum. Even if measurement of the antibodies is not a routine test, it can be of considerable value in disease diagnosis.

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A Survey on Treatment of Breast Cancer Patients with Korean Medicine: Preliminary Research for Clinical Practice Guidelines (한의표준임상진료지침 개발을 위한 유방암 보완치료 실태조사)

  • Kim, Nam-Hoon;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Lee, Jin-Wook;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Jang, Bo-Hyoung;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.165-178
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    • 2018
  • Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

The Relationship between Opioids Use, Cortisol and DHEAS (마약성 진통제 사용과 Cortisol 및 DHEAS와의 관계)

  • Jung, Ji Hoon;Choi, Youn Seon;Kim, Seon Mee;Lee, June Young;Kim, Eun Hye;Kim, Jung Eun;Kim, E Yeon;Park, Hee Jin;Yoon, Dong Jin
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.105-111
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    • 2015
  • Purpose: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. Methods: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. Results: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). Conclusion: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.