• Sleep Medicine and Psychophysiology
• /
• v.4 no.2
• /
• pp.172-180
• /
• 1997

Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

• The korean journal of orthodontics
• /
• v.30 no.3 s.80
• /
• pp.367-375
• /
• 2000

If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.

• Korean Journal of Psychosomatic Medicine
• /
• v.11 no.2
• /
• pp.196-204
• /
• 2003

Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.15 no.2
• /
• pp.160-167
• /
• 2004

Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

• Journal of Korean Academy of Nursing Administration
• /
• v.2 no.2
• /
• pp.97-107
• /
• 1996

Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

• Clinics in Shoulder and Elbow
• /
• v.10 no.1
• /
• pp.92-98
• /
• 2007

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

• The Journal of Korean Physical Therapy
• /
• v.5 no.1
• /
• pp.25-37
• /
• 1993

This study was conducted to investigate an attitude related to physical therapy students's clinical practice, a questionnaire survey was carried out for 101 third grader(Taegu Junior Health College 66, Andong Junior College 35) from 11th of January to 22th of March. The results are as follow : A. Frequency classified by item 1. Among preconception and anxiety on the clinical practice, a shortage of knowledge$(83.2\%)$ was the highest. 2. Among expectation on the clime practice, the chance to meet patients directly$(94.1\%)$ was the highest. 3. Among anxiety after students experienced clinical practice, a shortage of knowledge$(82.2\%)$ was the highest. 4. Among satisfaction after students experienced clinical practice, after students graduated college, they will maintain physical therapist's life continuously$(71.3\%)$ was the highest. B. The variables that showed statistical difference between general characteristics and variables classified by item are as follow : 1. Between sex and anxiety after students experienced clinical practice, girl-students$(86.7\%)$ showed higher rate than man-students$(61.1\%)$ in, a shortage of knowledge(P<0.01). 2. Between religion and expectation on clinical practice, religionists$(65.1\%)$ showed higher rate than nonreligionists $(44.8\%)$ in the chance to practice love for humanity(P<0.05). 3. Between religion and anxiety after students experienced clinical practice, religionist$(65.1\%)$ showed higher rate than nonreligionist$(56.9\%)$ in not unskillful counsel patients(P<0.01). 4. Between religion and satisfaction after students experienced clinical practice, religionist$(81.4\%)$ showed higher rate than nonreligionists$(63.3\%)$ in pride of major choice(P<0.01). 5. Between hospitalization experience of family and exportation on clinical practice, students who had hospitalization experience of family$(79.7\%)$ were higher rate than unexperienced students's$(62.2\%)$ in the chance to apply knowledge(P<0.05). 6. Between hospitalization experience and satisfaction after students experienced dime practice, students who had hospitalization experience$(68.4\%)$ were higher rate than unexperienced students's$(45.1\%)$ in settlement of anxiety(P<0.05). 1. Between choice motive of physiotherapy(PT) department and expectation on clinical practice, self-will students $(80.5\%)$ showed higher rate than other-will students's $(66.7\%)$ in rejoining participate in treatment(P<0.01). 8. Between choice motive of physiotherapy department and anxiety after students experienced clinical practice, self-will students$(74.0\%)$ showed higher rate than lither-will students's $(58.3\%)$ in the wish PT-job in the future(P<0.05). 9. Between choice motive of physiotherapy department and satisfaction after students experienced clinical practice, self-will students$(75.3\%)$ showed higher rate than other-will students's$(58.3\%)$ in pride on major in physical therapy(P<0.05). It was revealed by this survey that girl-students had higher anxiety than man-students in anxiety after students experiences clinical practice, self-will student had higher satisfaction higher than other-will student in the choice of physiotherapy department.

• Journal of Acupuncture Research
• /
• v.31 no.2
• /
• pp.165-171
• /
• 2014

Objectives : The purpose of this study was to examine and report improvements of facial wrinkles with the use of subcision. Methods : Subcision acupuncture was performed on outpatients with facial wrinkles for one to two times. Evaluation of improvement was conducted with patient-report questionnaires and comparison of before and after pictures. Items for satisfaction and adverse events were included in the questionnaire, and it was filled out after treatment. The photographs were taken three times; before the first and the second subcision acupuncture, and two to four weeks after the second subcision acupuncture. Results : The results from questionnaire and photo comparison were reported positive and satisfactory. There were minor adverse events such as bruise or conspicuousness of other wrinkles that were not treated. Conclusions : Our study results suggests that the use of subcision acupuncture is effective for facial wrinkles.

• Journal of Korean Medicine Rehabilitation
• /
• v.20 no.1
• /
• pp.193-208
• /
• 2010

Objectives : The purpose of this study is to investigate the clinical effects of cupping therapy on sleep disorders induced by traffic accidents. Methods : The 46 patients were divided into 2 groups : Exp.group was treated with cupping therapy at bedtime and Con.group was treated except cupping therapy at bedtime. To evaluate the efficiency of cupping therapy, the SMH sleep questionnaire and Visual Analogue Scale(VAS) were applied before treatment and after 7 days treatment. Results : 1. The Exp.group has improved statistical significantly in delaying bedtime and bedtime arousal as compared to the Con.group. 2. The Exp.group was increased in total sleep time but had no statistical significance as compared to the Con.group. 3. The Exp.group was improved in subjective evaluation of satisfaction with sleep, depth of sleep, the overall sleep and difficulty in falling asleep. Conclusions : Cupping therapy at bedtime has clinical effects of improvement of sleep disorder induced by traffic accidents.

• Journal of Korean Biological Nursing Science
• /
• v.13 no.1
• /
• pp.44-52
• /
• 2011

Purpose: The purpose of this study was to examine the effects of a preference music therapy on anxiety and pain of cystoscopy. Methods: This study was performed using the quasi-experimental study design with non-equivalent control group pre-test and post-test. Total of 76 adult clients admitted to a tertiary hospital located in Daegu, South Korea were selected by convenience sampling 19 in the control and 57 in the experimental group. The data were analyzed by $x^2$, t-test, paired t-test, and repeated measures ANOVA using SPSS 17.0. Results: Implementing a preference music therapy was found to be effective in reducing anxiety level before cystoscopy in the present study. However, there were no significant effects of this preference music therapy in reducing pain and anxiety during cystoscopy. In addition, there were no significant effects of a preference music therapy on the patients' satisfaction of the anxiety, discomfort, and pain relieving. Conclusion: The findings support that implementing a preference music therapy may reduce anxiety before the cyctoscopy procedure. Therefore, it can be suggested that a preference music therapy needs to be consider-ed as a regular nursing intervention to reduce patient anxiety level before cystoscopy.