• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.9
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• pp.203-215
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• 2017

Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.433-446
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• 2005

The purpose of this study was to investigate the sociopsychological factors which might influence the course of the temporomandibular disorders and to develop models for prediction of treatment outcome related to pain, dysfunction and sound. For this study, 268 patients with temporomandibular disorders were selected from the patients presented to department of Oral Medicine, Wonkwang university dental hospital. Chief complaints of these subjects were largely grouped into three categories such as pain, dysfunction and sound, and 10 cm visual analogue scale(VAS) was used to record the state of the three complaints every visit and Treatment Index(VAS TI) was calculated from VAS. All the forty-two items obtained from clinical examination or questionnaire were statistically processed with $SPSS^{(R)}$ windows. The results of this study were as follows: 1. The items showed a difference between male and female subjects were maximum mouth opening, palpation score, jaw jerk during mandibular movement, and sleep disturbance. Among questionnaires such as SRRS, HAD scale and PSQI, the HAD scales showed the most highly significant correlation with the each scale item of the SCL-90R. 2. Among the groups classified by VAS TI, the group with the lowest VAS TI showed the highest VAS score in the start of treatment but showed the lowest score in the end of treatment, without respect to the type of chief complaint. From these results, it is assumed that the active treatment duration for the subjects with lower VAS score in the first visit would be longer than the subjects with higher score with the somewhat poor treatment outcome. 3. With regard to all the three complaints, the items showing significant effect in the model for prediction of treatment outcome were from questionnaire, except one item, maximum mouth opening, which suggest that the sociopsychological factors would be strongly related to development and progress of the symptoms.

• Journal of Oriental Neuropsychiatry
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• v.31 no.1
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• pp.1-12
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• 2020

Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.98-104
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• 2012

Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.91-99
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• 1999

Objects：It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods：The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results：1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions：The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.

• Journal of the Korean Society of Food Culture
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• v.18 no.1
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• pp.45-55
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• 2003

To investigate the relationship between dietary attitude and healthy status of office workers in Seoul was to be researched for 389 subjects (male: 224 and female: 165). As a result showed 69.4% of them moderately healthy state and 55.0% had a great interest in health. About 41.6% of the respondents was nonsmoker and 74.8% of them drunk alcohol once or twice a week. Only 28.0% of them responded to have breakfast three to four times a week. About 71.0% responded to skip breakfast'. The main reasons for it were 'the lack of time'(46.5%) and 'habitually'(22.6%). The usually preferred taste of food was showed to be 'hot' for 40.3%, the highest percentage. An attempt of supplemental food was 66.0%. The reason for it was shown to be 'for relaxation'(51.7%), followed by 'for prevention and treatment of diseases (23.1%). On dietary habit showed the groups of married and professional people won the hish scores on it. And the groups of those doing exercise once or twice a week, those having a sufficient sleep and those kept in a good food habit showed the high scores on it. The older age group showed the good dietary attitude regardless of occupation.

• Journal of muscle and joint health
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• v.2 no.1
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• Sim-seong Yeon-gu
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• v.31 no.2
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• pp.113-150
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• 2016

Chobun refers to a temporary grave covered with straw thatch that contains a corpse until its flesh is gone. When all the flesh has rotted away, the straw grave is disassembled and only the bones are retrieved. Therefore, Chobun is an example of a secondary burial custom (German : Doppel Bestattung) that is composed of a first temporary funeral for processing the corpse's flesh, and a second permanent burial of the final remains (bones or ashes). The duration of the temporary burial is determined by the time needed for decomposing the flesh of the deceased. Building a Chobun progresses putrefaction and reduction to bone. In the literature of alchemy, putrefaction and new life occur simultaneously. The purpose of rotting is to make the flesh disappear, leaving only its essence. It is making the physical body enter a spiritual state, so that the dead can enter into a different world. One must endure the unstable rotting process until the smell of flesh has faded. The rotting process is the attitude of accepting the terrible, polluted aspect of the corpse, while maintaining a helpless, passive posture, in order to allow new possibilities. When we try to approach an archetypal aspect of the unconscious, it is often experienced in threatening, aggressive ways. In the individuation process, the unconscious offers us the blessing of a new spiritual awakening and renewed sense of life, only when we have the courage to see this terrifying and contaminated side of our psyche. This is exactly what putrefaction means. Bone and skeleton symbolize the indestructible, imperishable, and essential elements of life. Bone is the minimum unit and foundation for regeneration, where new life can grow. Reduction to bone is moving back to the origin of life, to the womb. Psychologically, it means discarding one's ego-centeredness and allowing the Self to lead the entire process of individuation. Going through the painful process of reduction to a skeleton for the purpose of further development is a declaration of the death of the ego, aiming at the liberation from perishable flesh and acquisition of the spiritual, regenerative, and immortal elements of life. Chobun also denotes the yearly decay and revival of life, especially of vegetal life. In Chobun, this symbolic meaning of the vegetal cycle of life is emphasized to represent the part of life that survives even after death. Vegetation related to Chobun deals with the continuity of life and psychologically with the Self. Images of vegetation are closely related to the existence of life beyond death, which is the existence of the Self, the source of energy that constantly renews and rejuvenates the consciousness.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.79-89
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• 1999

The purpose of this study is to compare health status and activities for the pain and no-pain groups in the elderly. The study subjects included 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes through interview using a closed-ended questionnaire from Nov. 6th. to Nov. 16th. 1997. The instrument used in the study was selected after carefully reviewing pain-related articles and records well described the characteristics of the elderly. The data were analysed by using descriptive statistics and chi-square tests. The findings were as follows : Of the 189 subjects, 83.6% reported experiencing the pain for the last year. By the age, there were significant differences between the pain and no-pain group(${\chi}^2$=9.572, p=.023). The percentage of the pain complainers was the highest in 80 years and older(100.0%), followed by 70~74(89.1%), 75~79(81.3%), 65~69(76.8%) which presented crude increase according to age. By sex, men had lower pain prevalence(69.5%) than that of women(90.0%). The number of pain complainers was higher in women than men(${\chi}^2$=12.448, p=.023). There were significant differences between the pain and no-pain groups by spouse distribution(${\chi}^2$=10.736, p=.001), educational state(${\chi}^2$=13.020, p=.000), occupation(${\chi}^2$=18.807, p=.000). Pain prevalence in the subjects having no spouse(59.3%) was higher than those having spouse(40.7%), Illiteracy rate was higher in pain group(49.0%) than no-pain group(13.3%). The number of the subjects having occupation(full time or part time) was fewer in pain group than no-pain group. By health status, there were significant differences between two groups(${\chi}^2$=40.055, p=.000). : the pain group showed poor(61.4%), followed by moderate(22.1%), good(16.5%) while no-pain group showed good(64.5%), moderate(29.0%), poor(6.5%). By activities, there were significant differences between the pain and no-pain groups. The pain group was disturbed more severely than the no-pain group in movement(${\chi}^2$=57.829, p=.000), sleep(${\chi}^2$=12.785, p=.000), usual activities(${\chi}^2$=39.196, p=.000), receiving guests(${\chi}^2$=13.163, p=.000), and hobbies and recreation(${\chi}^2$=28.177, p=.000).