• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.175-192
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• 1997

The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.283-290
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• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• Annals of Rehabilitation Medicine
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• v.41 no.6
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• pp.1019-1027
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• 2017

Objective To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI). Methods The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group. Results Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched 'e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched 'e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018). Conclusion In patients with suspected vocal cord palsy, impaired high pitched 'e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.215-224
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• 2006

Objectives : In order to apply useful data to clinical practice, we undertook this study and tried to find factors related with sequelae of facial palsy in relation with patients' age and gender distribution, past history with the disease, condition before onset, duration of recovery time, existence of remaining sequelae, types of the sequelae, and duration for sequelae to disappear. Methods : We evaluated patients' condition (fatigue, stress, chills, cold and so on), past history (diabetes mellitus, hypertension, stroke, herpes zoster, cancer and so on), duration of recovery time, types of the sequelae, age and sequelae distribution as to when the treatments were started as we examined 473 patients who were diagnosed with facial palsy, and visited the Out-patient Department of Acupuncture and Moxibustion of Bundang Oriental Medicine Hospital of Dongguk University through 2003 and 2004. Results : The sequelae of facial palsy were not significantly relevant to the signs found before facial palsy occurred(fatigue, stress, chills, and cold), or to patients' past history (hypertension, diabetes mellitus, facial palsy, herpes zoster). The duration of recovery time was within 30 days for 45.3% of the patients examined in this study, and within 90 days for 72.6%. Evaluating the existence of sequelae in relation to age, we found more in the group comprised of patients aged 50 and over than under 50. We found more sequelae in the group which is consisted of patients who had not been treated until 6 days after than within 5 days from the onset. Conclusion: Attention to sequelae will be needed for patients aged 50 and over and who were not treated until 6 days after the onset, as they had more sequelae.

• Journal of Korean Academy of Nursing
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• v.24 no.1
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• pp.18-32
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• 1994

It is important to understand that patients with hemiplegia are under stress during the rehabilitation process. This study was designed to determine what changes occur in the stress perceived by these patients during the rehabilitation process. and what changes occur in the ways they coped with stress. A decriptive study with a longitudinal design was conducted. A total of 57 patients with hemiplegia who were admitted to one general hospital made up the sample for this study. A questionnaire, observations and interviews were used for the data collection which was done in three phases(within one week after admission : within one week before discharge ; within one month after discharge ). Data were analyzed using t-test, ANOVA repeated measures of ANOVA, and post hoc paired t -test, Bonferroni correction. The results of this study are : 1. Changes in the perception of stress during the rehabilitation process : There was a statistically significant differencs in the perception of stress among these patients during the rehabilitation process. On the post-hoc test. the perception of stress showed a statistically significant decrease from admission to discharge. The perception of psychological stress was high during the rehabilitation process as compared with the perception of physical and social stress. 2. Changes in the way the patients coped during the rehabilitation process : On admission passive coping was used by most of the subjects(91.2％). Passive coping showed an decrease from admission to discharge, but an increase from discharge to follow-up at one month post discharge. There was, however, no statistically significant changes in the way the patients coped during the rehabilitation process. 3. Changes in perception of stress during the rehabilitation process according to variables. Perception of stress among patients classified as So-Um was higher during the rehabilitation process, when compared with patients classified as So- Yang and Tae-Um. There was, however, no statistically significant difference in perception of stress over time. The patients with right sided paralysis perceived higher stress than those with left sided paralysis. There was, however, no statistically significant difference in perception of stress over time. Hence, stress was not influenced by which side was paralyzed th frequency of the relapse of the disease, or the time in the rehabilitation process. 4. Changes in coping during the rehabilitation process according to variables. There was a statistically significant difference in the way the patients coped at follow- up according to the three different kinds of the constitution groups. In other words, coping was not used by patients classified as Tae-Um but was used by those classified as So-Um. On the repeated measures of ANOVA, there was a statstically significant difference in stress over time, and an interaction between constitution and time. But the way of coping during the rehabilitation process was not influenced by which side was paralyzed nor by the frequency of the relapse of the disease. In conclusion, perception of psychological stress was high during the rehabilitation process, as compared to perception of physical and social stress. There was a statistcally significant difference in the perception of stress over time, Perception of stress showed a gradual decrease from over admission to follow-up period. There was. however, no statistically significant difference in the way of coping over time. Passive coping was used by most of patients. In the study, these findings suggest a need for nursing care related to the psychological support for patients with hemiplegia both in the hospital as well as at home, and the need for education and counseling on independent self-care to help the hemiplegic patients adapt to stress using active coping.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.73-79
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• 2009

Purpose : We undertook this study to improve our understanding of the epidemiologic and clinical features of nonpolioenterovirus (NPEV) infections, especially enterovirus 71 (EV71) infections, in Korean children. Methods : Between April and June 2000, NPEVs were detected by RT-PCR and cultures of specimens obtained from patients with aseptic meningitis, acute respiratory disease, and acute gastroenteritis which were associated with enteroviral exanthem and vesicular pharyngeal enanthem, such as herpangina, and hand, foot, and mouth disease (HFMD). EV71 was identified by sequencing the VP1 gene. The clinical and epidemiologic data were analyzed retrospectively after all 87 NPEV-positive patients were divided into 4 groups, according to the clinical manifestations. Sixteen patients who mainly had symptoms of acute gastroenteritis were in group A, 21 patients with symptoms and signs of lower respiratory tract infections were in group B, 42 patients with a HFMD rash only were in group C with or without fever, and 8 patients with aseptic meningitis or paralysis were in group D. For the 11 EV71-positive patients, 1 was in group A, 2 were group B, 7 were in group C, and 1 was in group D. Results : There were 87 NPEV infections, including 11 EV71 infections. The mean age of the patients was 2 years and 11 months, ranging from 1 day to 15 years. There were no fatal cases among a total of 87 NPEV infections and no significant differences in clinical severity between the EV71 and other NPEV infections. Conclusion : NPEV infections in children were common during the 3 months in the spring of 2000. Unlike in southeast Asia, where fatal EV71 infection outbreaks have occurred since 1997, the clinical features of EV71 infection in Korean children are mild.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.26-33
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• 2021

Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘²=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘²=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.55-64
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• 1976

This paper presents the results of a survey for the causes of sensori-neural hearing impairment in Korea, The subjects were 1,676 children of total 2,928 enrolled in 16 Deaf Schools; two schools in each area of Seoul, Busan, Kyoungbook, Kyoungnam, Kyounggi and Chunbug, and each one in Chungnam, Chungbug, Chunnam and Jaeju. The data were collected by questionaire with 28 items distributed to their parents. The filling in the check lists were performed by their class teachers, interviewer, for 18 months from September, 1975 to february, 1976. The questionable or missed problems were reaffirmed. The results obtained were as follows. Most of the reasons, 78.5% were acquired characters that could be developed during pregnant period, the time of delivery and the time of after birth. The pure hereditary reasons except the cases complexed with one or two were only 11.3%. Those who could not be defined with any reasons were 10.2%. Among the acquired causes, 5.8% of total subjects were developed for pregnancy: 3.3%, during delivery; and 69.7%, after birth. In the pregnant period, the drug intoxications were 2.4% of total subjects, several diseases such as influenja, bleeding, surgical operation, venereal diseases and rubella etc. were about one percent, and the accompanied with some symptoms of pregnancy intoxication and traumatic events were 2.4%, During time, the cases with delayed rhythmical pain were 16 persons, the immaturities were 11, the asphyxial cases were nine, the errors of forceps delivery were seven, the cases of low body weight inspite of full term were four, the cases with cesarian section were three, the head injuries were two, and the accompanied with three kinds of above reasons were three. During after birth, the cases with acute communicable diseases were 35.4% of total subjects, the fever unknown origin were 16.1%, the chronic otitis media were 3.7%, the meningitis were 3.5%, the gastric and nutritional diseases were 3.5%, the drug intoxications were 4.8%, the blood diseases were 0.3% and the other causes were 2.2%. Here by acute communicable diseases, some importants were measle, 10.1% of total subjects; meningitis, 7.3%; convulsion with some reasons, 4.9%; poliomyelitis. 3.2%; encephalitis, 2.4%; and mumps, rubella, pertusis, scarlet fever, and small pox were somewhat played a role in. Among 59 cases with train diseases, 53 were concussion by the accidents, such as traffic and falling or sliping down etc., the cerebral paralysis and hydrocephalus were two, respectively. And the blood diseases were severe newjaundice in all five cases. If we were summarized with the above mentioned, most of the hearing impairments were introduced by the combined reasons with familial or hereditary factors and the acquired, than by a simple disease. Among the congenital or hereditary hearing impairments classified to now a day, we suppose that the many cases with the acquired causes during pregnancy, delivery and after birth were complexed. Subsequently, the maternal and child health should be more and more developed in our country, also.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1972.03a
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• pp.6-7
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• 1972

The air pollutants can be classified into the irritant gas and the asphixation gas, and the irritant gas is closely related to the otorhinolaryngological diseases. The common irritant gases are nitrogen oxides, sulfur oxides, hydrogen carbon compounds, and the potent and irritating PAN (peroxy acyl nitrate) which is secondarily liberated from photosynthesis. Those gases adhers to the mucous membrane to result in ulceration and secondary infection due to their potent oxidizing power. 1. Sulfur dioxide gas Sulfur dioxide gas has the typical characteristics of the air pollutants. Because of its high solubility it gets easily absorbed in the respiratory tract, when the symptoms and signs by irritation become manifested initially and later the resistance in the respiratory tract brings central about pulmonary edema and respiratory paralysis of origin. Chronic exposure to the gas leads to rhinitis, pharyngitis, laryngitis, and olfactory or gustatory disturbances. 2. Carbon monoxide Toxicity of carbon monoxide is due to its deprivation of the oxygen carrying capacity of the hemoglobin. The degree of the carbon monoxide intoxication varies according to its concentration and the duration of inhalation. It starts with headache, vertigo, nausea, vomiting and tinnitus, which can progress to respiratory difficulty, muscular laxity, syncope, and coma leading to death. 3. Nitrogen dioxide Nitrogen dioxide causes respiratory disturbances by formation of methemoglobin. In acute poisoning, it can cause pulmonary congestion, pulmonary edema, bronchitis, and pneumonia due to its strong irritation on the eyes and the nose. In chronic poisoning, it causes chronic pulmonary fibrosis and pulmonary edema. 4. Ozone It has offending irritating odor, and causes dryness of na sopharyngolaryngeal mucosa, headache and depressed pulmonary function which may eventually lead to pulmonary congestion or edema. 5. Smog The most outstanding incident of the smog occurred in London from December 5 through 8, 1952, because of which the mortality of the respiratory diseases increased fourfold. The smog was thought to be due to the smoke produced by incomplete combustion and its byproduct the sulfur oxides, and the dust was thought to play the secondary role. In new sense, hazardous is the photochemical smog which is produced by combination of light energy and the hydrocarbons and oxidant in the air. The Yonsei University Institute for Environmental :pollution Research launched a project to determine the relationship between the pollution and the medical, ophthalmological and rhinopharyngological disorders. The students (469) of the "S" Technical School in the most heavily polluted area in Pusan (Uham Dong district) were compared with those (345) of "K" High School in the less polluted area. The investigated group had those with subjective symptoms twice as much as the control group, 22.6% (106) in investigated group and 11.3% (39) in the control group. Among those symptomatic students of the investigated group. There were 29 with respiratory symptoms (29%), 22 with eye symptoms (21%), 50 with stuffy nose and rhinorrhea (47%), and 5 with sore thorat (5%), which revealed that more than half the students (52%) had subjective symptoms of the rhinopharyngological aspects. Physical examination revealed that the investigated group had more number of students with signs than those of the control group by 10%, 180 (38.4%) versus 99 (28.8%). Among the preceding 180 students of the investigated group, there were 8 with eye diseases (44%), 1 with respiratory disease (0.6%), 97 with rhinitis (54%), and 74 with pharyngotonsillitis (41%) which means that 95% of them had rharygoical diseases. The preceding data revealed that the otolaryngological diseases are conspicuously outnumbered in the heavily polluted area, and that there must be very close relationship between the air pollution and the otolaryngological diseases, and the anti-pollution measure is urgently needed.