• Journal of muscle and joint health
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• v.5 no.1
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.153-160
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• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• Korea journal of population studies
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• v.3 no.1
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• pp.42-51
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• 1979

A study on analysis of daily activities and time allocations of Community health Practitioners(CHP) and Community Health Aids(CHA) who assigned to Ocku Demonstration Health Project of the Korean Health Development Institute was conducted for one week from 3rd through 8th December 1979. The purpose of this study was to determine the efficacy including productivity of the community Health Workers developed by KHDI for rural areas. Five Community Health Practitioners and eight Community Health Aids were selected for the studies and their activities and time allocations were measured by designed format for one week. The following are the summary of the findings. 1. The mean age of the CHPs was 34.4 years with standard deviation 4.8 years, while that of CHAs was 26.9 years with standard deviation 3.1 years. 2. On educational background, all of the CHPs were graduated from Junior Nursing College, six CHAs were from high school and the rest of them from middle school. 3. On marital status, all CHPs were married, meanwhile four CHAs were married and the rest of them were single. 4. On service duration in public health fields, all of the CHPs have worked for less than three years, meanwhile five CHAs for 5 to 9 years and one CHA for more than 10 years. 5. Only one CHP lives in the myon where she works, and the rest of them live in other areas. Three CHAs live in the same myon where they work, and five live in other areas. 6. On types of work, the CHPs have worked on technical areas for 3.6 hours per day and on supportive and administrative activities for 2.7 hours and other activities for 1.8 hours on average. 7. The CHAs have spent 2.9 hours a day on technical activities, 4.2 hours on supportive and administrative activities and 1.6 hours on other activities in terms of time spent on average. 8. The average hours per day spent by CHPs on functional areas were 2.2 hours for clinic activities, 13.7 minutes for maternal health, 30.1 minutes for infant and child health, 13.4 minutes for family planning, 1.1 hours for supporting activities and 1.7 hours for administrative affairs. 9. The average hours per day spent by CHAs on functional areas were 4.1 hours for administrative affairs, 2.6 hours for supportive activities and only 2.9 for maternal health, infant and child health an family planning, and other technical works. 10. The average time spent by CHPs on clinical works were 1.0 minutes for history takings on disease, 2.6 minutes for physical examinations, 1.1 minutes for measurements, 3.8 minutes for administration of medications, 1.5 minutes for educations and 0.9 minutes for others. 11. On the average 92.8 percent of whole working hours of CHPs were spent in the substations, meanwhile 70.4 percent of CHAs were spent in the substations. 12. 17.8 percent of field working hours of CHAs were spent on the roal for their transportations. 13. The average time for unit service performance by CHPs were 10.9 minutes on clinical case, 18.1 minutes on maternal health, 14.8 minutes on infant and child health, 20.5 minutes on family planning and 29.9 minutes on tuberculosis control. 14. The average time for unit service performance by CHAs were 19.4 minutes on clinical work, 19.9 minutes on maternal health, 20.1 minutes on infant and child health, 17.2 minutes on family planning, 22.2 minutes on tuberculosis control.

• Journal of Life Science
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• v.31 no.12
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• pp.1110-1119
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• 2021

The purpose of this study was to investigate whether the inflammatory response in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages could be promoted by particulate matter 2.5 (PM_2.5) stimulation. To this end, the levels of inflammatory parameters, reactive oxygen species (ROS) and inflammation-regulating genes were investigated in RAW 264.7 cells treated with PM_2.5 in the presence or absence of LPS. Our results showed that the production levels of pro-inflammatory mediators (nitric oxide and prostaglandin E₂) and cytokines (interleukin-6 and -1β) were significantly increased by PM_2.5 stimulation in LPS-treated RAW 264.7 cells, which was correlated with increased expression genes involved in their production. In addition, when LPS-treated RAW 264.7 cells were exposed to PM_2.5, nuclear factor-kappaB (NF-κB) expression was further increased in the nucleus, and the expression of inhibitor of NF-κB as well as NF-κB in the cytoplasm was decreased. These results suggest that the co-treatment of PM_2.5 and LPS further increases the activation of the NF-κB signaling pathway compared to each treatment alone, thereby contributing to the promotion of transcriptional activity of inflammatory genes. Furthermore, although the generation of ROS was greatly increased by PM_2.5 in LPS-treated RAW 264.7 cells, the NF-κB inhibitor did not reduce the generation of ROS. In addition, when the generation of ROS was artificially suppressed, the production of inflammatory mediators and the activation of NF-κB were both abolished. Therefore, our results suggest that the increase in the NF-κB-mediated inflammatory response induced by PM_2.5 in LPS-treated RAW 264.7 macrophages was a ROS generation-dependent phenomenon.