• Archives of Plastic Surgery
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• 제45권6호
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• pp.534-541
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• 2018

Background Nipple-areolar complex (NAC) reconstruction following curative mastectomy is traditionally performed as a second-stage procedure several months after initial breast reconstruction. The recent literature has documented the increasing popularity of immediate nipple reconstruction carried out simultaneously during autologous reconstruction. The aim of this study was to evaluate the surgical outcomes and patient satisfaction with immediate breast and nipple reconstruction performed in a single stage after skin-sparing mastectomy. Methods All patients who underwent a skin-sparing mastectomy with immediate latissimus dorsi flap breast and NAC reconstruction as a single-stage procedure from 2007 to 2015 were included. Patient demographics, oncologic details, and surgical outcomes were recorded. The BREAST-Q questionnaire was administered to patients to assess the impact and effectiveness of this reconstructive strategy. Results During the study period, 34 breast and NAC reconstructions in 29 patients were performed at Cork University Hospital. The majority of our patient cohort were non-smokers (93.1%) and did not receive adjuvant radiotherapy. Postoperative complications were infrequent, with no cases of partial necrosis or complete loss of the nipple. The response rate to the BREAST-Q was 62% (n=18). Patients reported high levels of satisfaction with the reconstructed breast ($62{\pm}4$), nipple reconstruction ($61{\pm}4.8$), overall outcome ($74.3{\pm}5$), and psychosocial well-being ($77.7{\pm}3.2$). Conclusions Skin-sparing mastectomy with immediate nipple reconstruction during autologous latissimus dorsi reconstruction was demonstrated to be a safe and aesthetically reliable procedure in our cohort, yielding high levels of psychological and physical well-being. A single-stage procedure promotes psychosocial well-being involving issues that are intrinsically linked with breast cancer surgery.

• 디지털융복합연구
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• 제17권7호
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• pp.235-244
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• 2019

본 연구의 목적은 종합병원 간호사의 회복력과 조직문화가 웰빙에 미치는 영향을 파악하고자 함이다. 자료수집기간은 2017년 9월 1일부터 9월 30일까지였고, 종합병원에 근무중인 간호사 188명을 연구대상으로 하였다. 연구도구는 회복력, 조직문화 및 웰빙이었다. 자료분석은 SPSS/WIN 21.0 프로그램을 이용하여 기술통계, t-test, one-way ANOVA, Pearson's correlation coefficients, 단계적 다중회귀분석으로 하였다. 연구결과로 일반적 특성과 관련한 웰빙의 차이는 연령, 결혼상태, 직위 및 근무경력에서 유의미했다. 회복력, 조직문화 및 웰빙 간에는 모두 유의미한 양의 상관관계가 있었으며, 웰빙에 영향을 미치는 요인은 회복력, 업무지향 문화, 관계지향 문화 및 결혼상태 순이었다. 연구결과를 토대로, 웰빙을 위해 회복력을 강화하고 시대의 변화에 적응하고 수용할 수 있는 건강한 간호조직문화가 조성될 수 있도록 전략을 세워야 할 것이다. 이를 통해 간호사들의 건강증진은 물론 간호 소비자와 조직에도 긍정적인 영향을 줄 수 있을 것이다.

• 호스피스학술지
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• 제8권2호
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• pp.1-16
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• 2008

Hospice should help a patient maintain spiritual well-being and its attitudes toward death can have great effects on treatment and nursing of patients on terminal patient. The purpose of this study was to examine the differences in spiritual well-being and attitudes toward death due to taking a Hospice Subject in Nursing Students This is a comparative study design in which 31 senior nursing students of taking a hospice care subject and 27 senior nursing students of not taking a hospice care subject in college of nursing K university, that is located B metropolitan city in Korea. The instruments for spiritual well-being measuring tools was Kim's (2006) revision and complement of the translation by Choe (1990) on the basis of the spiritual well-being scale developed by Paloutzian and Ellison (1983). The instruments for attitudes toward death was researches revision and complement of the translation by Kim(1992) on the basis of the attitudes toward death Measuring Tool developed by Thorson and Powell (1988). Data were collected from June 1 through June 30, 2006; the researcher got permission from the subjcts, explained objectives of the research to subjects personally and got their permission, and distributed structured questionnaires to make a response in a self-administered basis. For data analysis, an SPSS WINDOWS 12.0 program was used for frequency, percentage, the mean, standard deviation, the minimum, the maximum, x2-test, ANCOVA, and Pearson's correlation coefficients. The main results of this research are as follows: 1. There were no differecnces the degree of spiritual well-being and the degree of attitudes toward death between nursing students who took a hospice subject and nursing students who did not take a hospice Subject, except several items of attitudes toward death. There was significant positive correlation (r= .508, p= .000) between subjects spiritual well-being and attitudes toward death. That is, the higher spiritual well-being, the more positive attitudes toward death. In conclusion, although there were no differecnces spiritual well-being and attitudes toward death between nursing students who took a hospice care subject and nursing students who did not take a hospice care subject, in nursing students, spiritual well-being was relatively high and their attitudes toward death was relatively positive. To help a nursing students make a positive change in attitudes toward death, a nursing intervention program is necessary to improve spiritual well-being.

• 기본간호학회지
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• 제18권2호
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• pp.237-246
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• 2011

Purpose: Family-caregivers of stroke patients usually go through hardship and life style changes during the protracted course of a family member's rehabilitation. There is need for programs to educate family-caregivers to better manage the medical crisis. In this study an evaluation was done of the degrees of burden and well-being experienced by primary family-caregivers following video-guided education (VGE) on rehabilitation and family lifestyle changes. Method: Fifty-eight primary family-caregivers of stroke patients on a neurological ward were divided into VGE (29) and control (29) groups. VGE was started within 7 days of patient admission. Interventions included VGE, counseling, and demonstration - re-demonstration. The control group received standard education but not VGE. Data were analyzed using Chi-square test, t-test, ANCOVA, and Pearson correlation coefficients with the SAS program. Results: The VGE group had a significantly lower score for total burden (F=7.19, p=.010) and for sub-scale of time-dependent burden (F=8.44, p=.005) than the control group. There was a negative correlation between primary family-caregiver burden and well-being (r=-.7151, p<.001). Conclusion: Results suggest that the rehabilitation program using VGE was an effective nursing intervention to reduce the burden of primary family-caregivers of stroke patients.

• Journal of Hospice and Palliative Care
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• 제12권4호
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• pp.209-219
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• 2009

목적: 본 연구는 단일군 사전 사후 원시실험설계 연구로서 호스피스완화의료병동 입원 환자를 위한 전인적 호스피스간호중재 프로그램("무지개 프로그램")의 자아존중감과 영적안녕에 대한 효과를 검증하고자 하였다. 방법: 2004년 4월 6일부터 2005년 4월 20일까지 경북포항시 소재 선린병원의 호스피스완화의료병동에 입원한 만18세 이상의 성인 환자로서 의사소통이 가능하여 연구참여에 서면 동의한 27명을 대상으로 사전조사 후 2주간, 총 10회(회당 120분)로 구성된 전인적 호스피스 간호중재 프로그램 제공 후, 사후 조사를 실시하였다. 효과 검정을 위해 자아존중감 측정 도구로는 성인용으로 수정보완된 Self Esteem Questionnaire (SEQ), 영적안녕 측정도구로는 Spiritual Well-being Questionnaire를 사용하였으며, 자료분석은 SPSS/WIN 12.0 프로그램을 이용하여 Paired t-test로 분석하였다. 결과: 1. 가설 1 '전인적 호스피스 간호중재 프로그램을 제공받은 호스피스완화의료병동 입원환자(이하 실험군)는 실험 전보다 실험 후의 자아존중감 정도가 높을 것이다'는 지지되었다(t=11.554, P<0.000) 2. 가설 2 '전인적 호스피스 간호중재 프로그램을 제공받은 실험군은 실험 전보다 실험 후의 영적안녕 정도가 높을 것이다'는 지지되었다(t=6.387, P<0.000). 결론: 전인적 호스피스간호중재 프로그램은 호스피스완화의료병동 입원환자의 자아존중감과 영적안녕을 증진시키는 데 효과적이므로, 호스피스완화의료 병동에 입원한 말기환자를 위해 임상 실무에서 적용 가능하며, 호스피스 전문직의 다학제적 팀 접근 모델로 연구, 교육 측면에서도 유용하리라 생각한다.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.191-195
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• 2007

Objectives : The aim of this study was to assess whether individuals who visit clinics to ask medical help for obesity treatment depict comparable levels of depression, body dissatisfaction, eating psychopathology and lower quality of life. Methods : This is a cross sectional study with 534 females who sought treatment for their obesity or overweight being recruited in seven clinical units in Seoul, Korea. The patients group was divided into two groups. The group 1 consisted of the patients with BMI >$25\;kg/m^2$. The women who showed BMI ${\leq}\;25\;kg/m^2$ among patients recruited for this study were classified as the group 2. The control group (group 3) was composed of 398 healthy females who have never tried to lose weight. Results : We found that group 1 had higher frequency of more than moderate level of depression than group 2 and group3 did. Both patients groups showed greater eating disordered attitudes and behaviors regardless of obese condition than the control group. Group1 showed relatively lower level of quality of life than group2 and group3 in terms of the quality of life related to physical well-being. In addition, the control group reported higher quality of life in psychological health than both patients groups did. Conclusions : In conclusion, it is necessary for clinicians to make a careful evaluation of depressive tendency and eating disorders when obese women seek for medical help. The combination of medical treatment and psychological approach for obese women would result in higher quality of life.

• 가정∙방문간호학회지
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• 제3권
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• pp.86-97
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• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3129-3133
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• 2012

Diagnosis and treatment procedures in cancers and resulting anxiety negatively affect the individual and the family. Particularly treatment methods may generate psychological symptoms. The aim of this study was to determine the level of such symptoms in Turkish gynecologic cancer patients receiving chemotherapy. A total of 41 patients who were referred to our gynecologic oncology research clinic between January-March 2012, receiving 3 months or more chemotherapy and who agreed to participate were enrolled in study. All the data were collected using a personal information form, Edmonton Symptom Assesment System and State-Trait Anxiety Inventory. Patients received highest point average from fatigue symptom ($6.53{\pm}2.67$) and lowest point average from dyspnea ($1.53{\pm}3.03$) according to Edmonton Symptom Assesment System. The mean State Anxiety score of patients was $43.1{\pm}9.77$ and mean Trait Anxiety score was $46.7{\pm}7.01$. Comparing symptoms of patients and mean State Anxiety score it was found that there was a statistically significant corelation with symptoms like pain (p<0.05), sadness (p<0.001), insomnia (p<0.05), state of well being (p<0.001) and dyspnea (p<0.05). Similarly comparing symptoms of patients and mean Trait Anxiety score demonstrated significant correlations for fatigue (p<0.05), sadness (p<0.01), insomnia (p<0.01) and state of well-being (p<0.01). As a result, patients with gynecological cancers experienced symptoms related to chemotherapy and a moderate level of anxiety. In accordance, appropriate interventions should recommended for the evaluation and improvement of anxiety and symptoms related to treatment in cancer patients.

• Journal of Hospice and Palliative Care
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• 제16권3호
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• pp.175-182
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• 2013

목적: 말기암환자의 영성은 호스피스완화의료에서 중요하게 고려되어야 할 영역이지만 아직 이에 대한 연구자료가 부족하다. 따라서 이번 연구에서는 호스피스 병동에 입원해 있는 말기 암환자들을 대상으로 영적 안녕과 통증, 불안 및 우울과의 연관성에 대하여 살펴보았다. 방법: 서울소재 일개 대학병원에 입원해 있는 환자를 대상으로 연구자와 연구간호사가 연구에 동의한 50명의 환자에게 자기 기입식 설문지를 배부하는 방법으로 설문을 시행하였다. 영적 안녕지수의 측정은 Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp)의 영적 상태 12문항을 이용하였으며 병원 우울불안지수는 Hospital anxiety and depression scale (HADS), 통증지수의 측정은 BPI-K를 이용하였다. 수집된 자료는 Spearmans' rank test, T-test, univariate and multivariate regression analysis를 이용하여 분석하였다. 결과: 영적 안녕은 평균 통증 강도(r=-0.283, P<0.05), 불안 하부척도(HADS-A)(r=-0.613, P<0.05), 우울 하부척도(HADS-D)(r=-0.526, P<0.05)와 상관관계를 보였다. 다른 변수들의 영향을 보정한 뒤에도 영적 안녕은 종교유무(OR=9.193, 95% CI=4.158~14.229, P<0.001)와 불안하부척도(OR=-1.03, 95% CI=-1.657~-0.403, P=0.002)와 유의한 상관관계를 보였다. 결론: 말기암환자의 영적 안녕감은 통증, 우울, 불안 점수와 유의한 상관관계를 가졌으며 종교가 있고 우울지수가 낮은 경우 영적 안녕감의 증가와 유의한 상관관계를 가졌다. 추후 전향적 연구를 통한 영적 말기암환자의 영적 중재 및 영적 지지에 대한 노력이 필요할 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3715-3720
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• 2014

Background: It is controversial whether Tai Chi (TC) benefits breast cancer survivors (BCS) on quality of life (QoL). We therefore undertook a meta-analysis to assess this question. Materials and Methods: A computerized search through electronic databases was performed to identify relevant randomized controlled trials (RCTs). The primary outcome was QoL, while secondary outcomes included body mass index (BMI), bone mineral density (BMD), and muscle strength. Results: Five RCTs involving 407 patients were included in the meta-analysis. The pooled standardized mean differences were 0.10 (95% confidence interval (CI): -0.35-0.54) for physical well-being, 0.03 (95%CI: -0.18-0.25) for social/family well-being, 0.24 (95%CI: 0.02-0.45) for emotional well-being, 0.23 (95%CI: -0.03-0.49) for functional well-being, and 0.09 (95%CI: -0.19-0.36) for additional concerns. TC failed to improve BMI, BMD, and muscle strength. Conclusions: There is currently lack of sufficient evidence to support TC improving QoL and other important clinical endpoints.