• 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 the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.188-198
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• 2016

This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.232-237
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• 2004

Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

• Journal of agricultural medicine and community health
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• v.40 no.3
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• pp.115-125
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• 2015

Objectives: Colorectal cancer is one of the major cancers in South Korea. We described the time trends in colorectal cancer incidence in Daejeon, a metropolitan city, and Chungcheongnam-do (Chungnam), a rural province, South Korea. Methods: Using the databases from the Daejeon Cancer Registry (DCR) and the Chungnam Cancer Registry (CCR), age-standardized (to world standard population) rates for incidence (ASRW) were calculated. Average annual percent change (AAPC) was assessed as a trend indicator. The completeness (such as the mortality/incidence ratio) and validity (such as the death certificate only %, microscopic verification %, primary site uncertain %, and age unknown %) were analyzed to examine the data quality of DCR and CCR. Results: Incidence of colorectal cancer showed increasing trend in both sexes. Over the years 2000-2012 in Daejeon, ASRW was increased significantly from 37.2 to 51.7 per 100,000 person-years (AAPC, 3.9%) among men and from 17.1 to 28.4 (AAPC, 3.9%) among women, respectively. In Chungnam, ASRW was also increased from 29.8 to 50.1 per 100,000 person-years (AAPC, 5.1%) among men and from 15.9 to 26.6 (AAPC, 3.2%) among women, respectively. The AAPC for colon cancer was greater than rectal cancer in both Daejeon and Chungnam. The trend of rectal cancer incidence was differ by sex (AAPC in men vs women, 2.7% vs 1.7% in Daejeon; 3.5% vs 0.8% in Chungnam). Indices of completeness and validity showed that the quality control of DCR and CCR was adequate to describe the trends of ASRW. Conclusions: Both Daejeon and Chungnam have had a rapid increase in colorectal cancer incidence. Monitoring and intervention are required on the risk factors which may contribute to this trend.

• Journal of the Korean Applied Science and Technology
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• v.36 no.2
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• pp.656-667
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• 2019

This study is a descriptive research to grasp the effects of job stress on turnover intention and to confirm the mediating effect of organizational commitment according to the extent of job stress, organizational commitment and turnover intention in the relations between job stress and Turnover Intention of nurses working in general hospitals. Method: The subjects of this study were 199 nurses are working in general hospitals, that have more than 200 beds and less than 400 beds, located in Gwangju. I surveyed them using a structured questionnaire for collecting data from Sep. 01, 2017 to Sep. 20, 2017. The collected data were analyzed by the frequency, the percentage, t-test, ANOVA, Scheffe's Test, Pearson's Correlation Coefficient, Multiple Regression Analysis and Sobel Results: In the first step, job stress as an independent variable had a statistically significant effect on organizational commitment(${\beta}=-.321$, p<.001). In the second step, job stress, an independent variable, also had an important effect on turnover intention as a dependent variable(${\beta}=.389$, p<.001). Job stress and organizational commitment were meaningful predictor variables of turnover intention in the third step. The explanatory power of two variables was 45.5%. The value ${\beta}$ of job stress in the third step was .203(p<.001) which was smaller than its value ${\beta}$,.389(p<.001), in the second step. That meant organizational commitment had the mediating effect on turnover intention. The Sobel Test was conducted to verify the significance of the extent of the mediating effects of organizational commitment. The test result was that the value Z was -3.694 and the mediating effect of organizational commitment was significant on the relation between job stress and turnover intention(p<.002). Conclusion: this study is expected be useful to find ways to reduce subjects' turnover intention by decreasing their job stress, increasing their organizational commitment and developing intervention programs as basic data.

• Journal of Industrial Convergence
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• v.20 no.9
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• pp.59-70
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• 2022

Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.