• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.109-129
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• 1994

Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

• The Korean Journal of Food And Nutrition
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• v.11 no.1
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• pp.87-98
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• 1998

This study was conducted to investigate Osteoporosis on the effect of dietary factors and past young age period's dairy products consumption on BMD in 170 postmenopausal Korean women without diagnosed disease. Bone mineral density(BMD) of lumbar spine was investigated by dual energy X-ray absorptiometry. Dietary assesment of the subjects were measured by Cognitive Food Frequency Recall method. The measurements of group average were 57.9kg of body weight, 36.73 of BMI(Body Mass Index), 2103.3㎉ of energy, 638.7mg of dietary calcium, 70.3g of protein, and 10.58mg of iron. Nutrient intake levels were similar to or more than the level of Korean Recommended Dietary Allowances. Bone Mineral Density(BMD) of Lumbar spine(L2-L4) of group average was 0.912g/$\textrm{cm}^2$, and under 50 yr's 1,02g/$\textrm{cm}^2$, 50~54 yr's 0.92g/$\textrm{cm}^2$, 55~59 yr's 0.85g/$\textrm{cm}^2$, over 60 yr's 0.85g/$\textrm{cm}^2$, had been getting low degree on aging. BMD of the Lumbar spine was positively correlated with calorie, body weight, dietary calcium, protein, phosphorus and serum albumin. Past dairy products consumption experiment was highly significant on BMD in teenage period(R square = 26, p-value 0.0031). Particularly in over 60 yr group, the correlations between BMD and past dairy products consumption in teenage period had shown highly significance(r=0.48, p<0.02). 55~59 yr age group had also positive correlation(R squae = 0.29, p<0.05). This results confirm that the most effective way of preventing osteoporosis and the fractures is to maximize peak bone mass in early life and to minimize bone loss through the balanced intake of Ca and other nutrients and regular physical activity.

• Asian Oncology Nursing
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• v.1 no.2
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• pp.191-203
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• 2001

The health of a nurse is very important because her mental and physical health can influence toward nursing patients directly, Especially, Cancer patients are growing annually. Also, terminal cancer patients' nursing and dead place are increasingly using hospital and the period of nursing for cancer patients are increasing. Nursing for cancer patients are different with acute disease. Therefore, I analysed comparing nurses' health working in cancer and general ward so that nurses working at cancer ward could be developed as a professional nurse, and I wanted to establish the foundation of nursing administration and reasonable manpower management to supply good quality of nursing to patients. In my research, I selected 117 nurses working in cancer ward and 134 nurses working in general word to analyse the stress rate and nurse's health comparing nurses working in general ward and cancer ward. The survey was conducted of nurses working in cancer ward nurses in 2 university hospitals, nurses working in a cancer hospital, and general ward nurses working in 3 public hospital. Also, the data was collected from Sep. 13, 2001 to Sep. 28, 2001. As health measuring tool, I used Cornell Medical Index(CMI) which are developed to fit Koreans by Ko Ungrin and Park Hang-bas (1980) using Cornell Medical Services which were designed by Weiser, Brosman, Mittelman, Wechler, Wolff in Cornell University(1945). As working stress measuring tool, I used Questionaries which were designed by Kim Mae-ja and Ku Mi-ok(1984) and then developed by Bae In-sook(1996). For managing the data, I used frequency, percentage, ${\chi}^2$ verification, t-test, and F-test (ANOVA). And in the case of significant data(p<.05). I did Duncan's test for post verification. The mutual relation between health condition and working stress rate have been conducted using Pearson's Correlation Coefficient. Followings are the results of my research. 1. Two groups showed significant differency at age after testing homogeneous character between two groups (${\chi}^2$ =9.919, p=.007). 2. Comparing two group's health condition, cancer ward(average 19.35${\pm}$18.34) were higher than general ward(14.42${\pm}$10.59) and showed statistical significant differency(p=.009). And, comparing two group's mental condition, cancer ward(9.00${\pm}$9.79) were higher than general ward(7.13${\pm}$6.35) and statistically no differency. 3. After comparing two group's working stress rate, the rate of cancer ward nurse's working stress(3.36${\pm}$.50) is higher than general ward nurse (3.32${\pm}$.48). There are no significant differency. However, in the detailed verification test, there were significant differency at inappropriate compensation (t=3.254, p=.001) and medication issue (t=2.170, p=.031). 4. After comparing health condition at general points, physical health condition showed significant differency at age(p=.020), the number of children (p=.015), religion (p=.015), position(p=.005), career(p=.008), working satisfaction(p=.003), activity after office hour(p=.045); and mental health condition showed significant differency at position(p=.010), career (p=.017), working satisfaction (p=.003). 5. After comparing the working stress rate according to general points, there were significant differency at working satisfaction (F=5.285, p=.006), predicted nursing(F=3.822, p=.023). 6. At the relation of health condition and working stress rate between two groups. physical and mental condition showed significant relation with working stress rate. i.e, if a nurse's health condition is not good, she are feeling much more stress than others. After considering all the factors in my research, I found that the health condition and stress rate of cancer ward nurses is much higher than general ward nurses. Considering that cancer ward nurses is necessary to care for increasing cancer patients with mental and physical nursing, the less stress for cancer ward nurses is very important to develop nursing quality and working efficiency by keeping good health condition, specializing cancer ward nurses. Therefore, we need following studies to find the factors which are effecting to cancer ward nurses' health and specialization. Also, we need to improve managing working condition to decrease working stress by improving working condition.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.643-647
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• 2006

Purpose : Recently, incidences of chronic cough with allergic disease have been increased. The identification of specific allergens for chronically coughing children is significant for diagnosis, proper treatment and prevention. The aim of this study was to identify significant contributors for sensitization in chronically coughing children. Methods : A total of 106 children, aged 1-6 years, visiting for chronic cough(>3 weeks), were tested for inhalant multiple allergosorbent assay(MAST), eosinophil count and total IgE. Parents completed a questionnaire on past history of atopy(infantile eczema) and bronchiolitis, family history of allergy, breastfeeding, smoking, pets and floor coverings at home. Results : Significant contributors for sensitization were : age(4-6 years), infantile eczema, positive family history of allergy and smoking by family. Conclusion : We were able to identify significant contributors for sensitization in chronically coughing children.

• The Korean Journal of Nuclear Medicine
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• v.36 no.5
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• pp.298-305
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• 2002

Purpose: Bone marrow scintigraphy has been used to evaluate the status of bone marrow in various hematologic disorders. We have analyzed the peripheral distribution pattern and central uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody and the their correlation in patients with various hematologic malignancy. Materials and Methods: Bone marrow immunoscintigraphy was performed using Tc-99m anti-granulocyte monoclonal mouse antibody BW 250/183. Fifty patients were classified into four groups; 11 with acute myelogenous leukemia, 12 with acute lymphocytic leukemia, 15 with lymphoma and 12 with myelodysplastic syndrome. The extension of peripheral bone marrow was categorized into four grades: I, II, III and IV. The activity of central bene marrow was expressed as sacroiliac uptake ratio. Results: The patient's number was 4 in grade I, 27 in grade II, 15 in grade III and 4 in grade IV according to extension of peripheral bone marrow. The extension of peripheral bone marrow was marked (58% in grade III and IV) in myelodysplastic syndrome and acute lymphocytic leukemia and mild (93% in grade I and II) in lymphoma. Sacroiliac uptake ratio was highest ($8.5{\pm}4.0$) in myelodysplastic syndrome and lowest ($5.9{\pm}3.6$) in acute myelogenous leukemia, but not significantly different among four patient groups (p>0.05). Sacroiliac uptake ratio of whole patients was significantly different among four grades (p=0.003), but there was not correlated between grade of peripheral bone marrow and sacroiliac uptake ratio (r=0.05). Conclusion: The pattern of peripheral bone marrow extension and activity of central hemopoietic marrow were not specific to the disease entities. Response of hemopoietic bone marrow may be evaluated on both peripheral and central bone marrow in patients with hematologic malignancy.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.167-174
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• 2005

Purpose : Relapses are a major problem in children with steroid responsive nephrotic syndrome(SRNS). This study has been performed to determine the predictive factors for relapse in children with SRNS. Methods : The study group consisted of 7,3 children with SRNS who had been admitted to the Department of Pediatrics, Kyungpook National University Hospital, over 6 years from 1996 to 2001. The medical records were reviewed retrospectively and analyzed to determine significant relationships between selected variables[age at onset, sex, laboratory data, the rapidity of response(days to remission), interval to first relapse] and the frequency of relapse. Results : The age($mean{\pm}SD$) of patients was $4.53{\pm}2.53$ years old. The male to female ratio was 52:21. In 95$\%$, 39 out of the 41 children had a renal biopsy, and the final diagnosis was minimal change nephrotic syndrome. There was no significant correlation between the frequency of relapse and the following variables age at onset, sex, and presence of hematuria. However, the rapidity of response correlated well with the frequency of relapse, especially during the first year after the onset of the disease(P=0.005). Conclusion : The rapidity of response is expected to be one of the predictive (actors for relapse in children with SRNS. (J Korean Soc Pediatr Nephrol 2005;9:167-174)

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.315-322
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• 2008

Purpose : Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. Methods : Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). Results : Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. Conclusion : Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.18-26
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• 2013

Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1242-1247
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• 2003

Purpose : Gastroesophageal reflux disease(GERD) is known as one of the most common causes of chronic cough, especially in children. The purpose of this study is to evaluate the efficacy of parameters from proximal esophageal 24-hr pH monitoring through its comparison with those of distal esophageal 24-hr pH monitoring that we generally use for diagnosis of GERD. Methods : We performed chest CT scans to find out the cause of chronic cough in infants with no clinical manifestation suggesting GERD. Then, in case that they had air space consolidation in posterior segment of both upper lobes and superior segment of both lower lobes(dependent position), we performed proximal and distal esophageal 24-hr pH monitoring. Results : The proximal and distal pH monitoring were performed in 17 infants(male 12; female five). The patients with positive pathologic reflux in proximal esophagus were 15 of 17(88.2%) and in distal esophagus were four of 17(23.5%). Reflux index and the total number of reflux episodes were statistically significantly lower in the proximal than in the distal esophagus(P<0.05). There was no correlation between each parameters of proximal and distal esophageal 24-hr pH monitoring. Conclusion : This study suggests that proximal esophageal 24-hr pH monitoring can be used as a very useful diagnostic tool in infants with chronic cough in which there are suspicions that it resulted from aspiration due to GERD.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.230-235
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• 2003

Purpose : Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured $IFN-{\gamma}$(Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma. Methods : We measured IL-5, ECP, $IFN-{\gamma}$ levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases. Results : IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. $IFN-{\gamma}$ levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups. Conclusion : We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.