Aim : The purpose of this study was to investigate the hypothesis that treatment with self-checking behavior management program was valuable in the management of temporomandibular disorders compared with a existing method treatment group. Methods : All participants who are diagnosed with temporomandibular disorders were treated with medication and physical therapy. They came into the clinic at intervals of two weeks, three times. The signs and symptoms were assessed investigating Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS at every visit. Experimental group received instructions repeatedly by using self evaluation questionnaire. Control group was educated once at the beginning of treatment. The difference Pain NRS, MCO, Noise NRS, LOM NRS between first and second visits, first and third visits were estimated.. Result :Experimental group showed greater improvement on MCO difference after stopping medication(p=0.001). This improvements were prominent in the male(p=0.001) and the first or second decade of the patients(p=0.004). Conclusion : The present study showed that there was better result when educating repeatedly with using self evaluation questionnaire than educating once at the beginning of the treatment.
Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.
The purpose of this study is to understand in-depth the effect of self-directed practice in for core fundamental nursing skills applying reciprocal peer tutoring on the learning of nursing college students. The study participants were 15 students in the 4th grade of the department of nursing, and data were collected through in-depth interviews. The results of analysis resulted in four themes: 'motivation of learning', 'self-directed learning', 'improving achievement', and 'insufficient learning requirements'. The core fundamental nursing skills applying reciprocal peer tutoring has a positive experience of inducing motivation of learning for participants through a comfortable environment and improving self-confidence, and gaining opportunities to lead prior learning and learn in the learner's language. However, there have been experiences where additional knowledge expansion is difficult and feelings of insecurity is felt due to insufficient learning requirements. Therefore, when applying the reciprocal peer tutoring method to self-directed practice, it is considered to be effective if the professor applies a method that can sufficiently satisfy the learner's learning needs.
Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.
Purpose: This study was done to develop and evaluate a drug dosage calculation training program using cognitive loading theory based on a smartphone application. Calculation ability, dosage calculation related self-efficacy and anxiety were measured. Methods: A nonequivalent control group design was used. Smartphone application and a handout for self-study were developed and administered to the experimental group and only a handout was provided for control group. Intervention period was 4 weeks. Data were analyzed using descriptive analysis, ${\chi}^2$-test, t-test, and ANCOVA with the SPSS 18.0. Results: The experimental group showed more 'self-efficacy for drug dosage calculation' than the control group (t=3.82, p<.001). Experimental group students had higher ability to perform drug dosage calculations than control group students (t=3.98, p<.001), with regard to 'metric conversion' (t=2.25, p =.027), 'table dosage calculation' (t=2.20, p =.031) and 'drop rate calculation' (t=4.60, p<.001). There was no difference in improvement in 'anxiety for drug dosage calculation'. Mean satisfaction score for the program was 86.1. Conclusion: These results indicate that this drug dosage calculation training program using smartphone application is effective in improving dosage calculation related self-efficacy and calculation ability. Further study should be done to develop additional interventions for reducing anxiety.
Objectives: Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort. Methods: The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard. Results: Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency. Conclusions: The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.
Factors related to health promotion activities and quality of life in Korean women with arthritis have not been clearly identified. Predictors of health promotion might be identified that will enhance the well - being of this group. Accordingly, the findings of the study will contribute additional information about the relationship between health promotion and quality of life and will add to the research on quality of life of individuals with a leading cause of disability--arthritis. The purpose of the study was to examine the relationship of selected background factors (years of illness, perceived severity of illness, uncertainty in illness), perceived self- efficacy, and health promoting behaviors to the quality of life of Korean women with arthritis. A cross - sectional descriptive design was used in this study to investigate relationships among the variables of interest. The sample was composed of 96 women who had arhtrits and visited large university hospital in Seoul for regular check up or pre-scription of medication. The purpose of a descriptive correlational design was to determine the absence or presence of relationships among variables that were measurable (Polit & Hungler, 1981, p.147). The design of this study was appropriate because it yielded answers to the research questions and hypotheses regarding the relationships among the model variables. the Questionnaire contained demographic information, translated Mishel Uncertainty in illness Scale-Community form (MUIS-C) (Mishel, 1987), translated and modified Disease Course Graphic Scale(DCGS) which was developed by Braden (1990), translated Sherer. et al.’s General Self-Efficacy Scale (1982), The Health -Promoting Lifestyle Profile (HPLP), developed by Walker, Sechrist, and Fender (1987) and traslated to Korean by Ha, and quality of life was measured by Face Scale (Andrew, 1976). Several steps of verification for the translation process were carefully conducted. Data analysis included descriptive correlational statistics and multiple regression techniques. Health promotion was the only contributor to pre-dict quality of life. Results showed that enabling cognitive perceptual factor (self-efficacy) mediates the disruptive force (uncertainty in ill-ness) on achieving a health promoting self- help behavior. The findings of this study also indicated that illness - related variable of severity of illness was mediated by health promotion, which buffered it's impact on quality of life.
Journal of Korean Academy of Fundamentals of Nursing
/
v.21
no.2
/
pp.162-173
/
2014
Purpose: This study was done to identify learning experiences and self-confidence and to analyze nursing students' self-confidence according to learning experiences for core nursing skills (CNS). Method: Participants were 502 final year nursing students. Data were collected using a structured questionnaire and analyzed using descriptive statistics and t-test. Results: Over 60% of participants had practiced 15 items of the 24 CNS in the basic nursing lab (BNL). In clinical practice (CP), they had practiced five items but experienced only one item in a simulation lab (SL). Items with the highest confidence level were vital signs (4.69) followed by blood sugar test (4.60), pulse oximeter (4.38), and oral medication (4.12). Items with the lowest confidence level were blood transfusion (2.17) followed by enema (2.64) and indwelling catheterization (2.67). The group with CNS experience in the practice curriculum was generally more confident than the group with no experience. Self-confidences in some skills was significantly different depending on availability of SL, credits for BNL and CP, and presence of preceptors. Conclusion: Results indicate a need to develop practice education strategies such as changing the CP to practice-centered learning with preceptors and including well-designed SL to increase confidence of nursing students.
Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x2 test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.
Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.
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