• Title/Summary/Keyword: 질병 불확실성

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The Influence of Disease Activity and Uncertainty on Anxiety and Depression in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 질병활성도와 불확실성이 불안과 우울에 미치는 영향)

  • Lim, Jong-Mi;Cho, Ok-Hee
    • Journal of Home Health Care Nursing
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    • v.24 no.1
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    • pp.61-68
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    • 2017
  • Purpose: The purpose of this study was to understand how disease activity and uncertainty influence anxiety and depression in patients with ankylosing spondylitis Methods: Participants were 125 patients with ankylosing spondylitis who had attended the rheumatology division of a university hospital. A structured questionnaire was used to assess disease activity, uncertainty, anxiety, and depression. The data gathered were analyzed using t-tests, ANOVAs, Pearson correlation coefficients, and a multiple regression. Results: Differences were observed in anxiety based on job status, and in depression based on age, marriage, and job status. Uncertainty and disease activity predicted patients' anxiety and explained 40% of the variance in this measure, and the relative influence of uncertainty (${\beta}=.38$, p<.001) was larger than that of disease activity (${\beta}=.30$, p<.001). Furthermore, uncertainty and disease activity predicted depression and explained 36% of the variance therein, and the relative influence of uncertainty (${\beta}=.27$, p=.002) and disease activity (${\beta}=.27$, p=.003) was similar. Conclusion: This study confirmed that disease activity and uncertainty influenced anxiety and depression in patients with ankylosing spondylitis. Therefore, efforts to decrease anxiety and depression in patients with this condition must take into consideration disease activity when implementing nursing interventions and should include strategies to lower uncertainty.

진단검사(Diagnostic test)의 정확도 추정

  • 박선일
    • Journal of the korean veterinary medical association
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    • v.37 no.11
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    • pp.1001-1022
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    • 2001
  • 수의사의 의사결정 과정에는 모든 의료행위에 내재된 본질적인 특성인 불확실성 (uncertainty)이라는 문제가 필연적으로 개입되는데 특히 진단검사와 관련된 신뢰도와 정확도 측면에서는 더욱 그러하다. 기존의 진단방법에 대체할만한 새로운 검사법이 개발되었을 때 실제로 이를 임상적 진단에 활용하기 위해서는 이 검사의 민감도와 특이도를 추정하는 작업은 필수적이다. 예컨대 표준검사법 (gold standard)이 제시되어 잇을 경우 비교적 간단한 계산으로 추정이 가능하지만 대부분의 질병에서와 같이 표준검사법이 없을 경우에는 상당한 통계적 지식을 요구한다. 또한 소위 표준검사법이라고 하는 검사도 실제로 질병에 이환된 집단과 이환되지 않은 집단을 완벽히 이분해주는 (dichotomize) 능력을 가진 것이라고는 볼 수 없기 때문에 추정과정에 신중을 기해야 한다. 본 원고에서는 다양한 상황에서의 진단검사의 민감도와 특이도를 추정하는 방법에 대하여 기술하며 본 원고에서 설명한 내용과 유사한 자료에 대하여 분석을 원하는 독자는 저자에게 연락을 주면 자세한 분석절차에 대하여 논의가 가능하다.

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An Attribute Ordering Optimization in Bayesian Networks for Prognostic Modeling of the Metabolic Syndrome (대사증후군의 예측 모델링을 위한 베이지안 네트워크의 속성 순서 최적화)

  • Park Han-Saem;Cho Sung-Bae
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.06a
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    • pp.1-3
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    • 2006
  • 대사증후군은 당뇨병, 고혈압, 복부 비만, 고지혈증 등의 질병이 한 개인에게 동시에 발현하는 것을 말하며, 최근 경제여건의 향상 및 식생활 습관의 변화와 함께 우리나라에서도 심각한 문제가 되고 있다. 한편 불확실성의 처리를 위해 많이 사용되는 베이지안 네트워크는 사람이 분석 가능한 확률 기반의 모델로 최근 의학분야에서 질병의 진단이나 예측모델을 구성하기 위한 방법으로 유용하게 사용되고 있다. 베이지안 네트워크의 구조를 학습하는 대표적인 알고리즘인 K2 알고리즘은 속성이 입력되는 순서의 영향을 받으며, 따라서 이 또한 하나의 주제로써 연구되어 왔다. 본 논문에서는 유전자 알고리즘을 이용하여 베이지안 네트워크에 입력되는 속성 순서를 최적화하며 이 과정에서 의학지식을 적용해 효율적인 최적화가 가능하도록 하였다. 제안하는 모델을 통해 1993년의 데이터를 가지고 1995년의 상태를 예측하는 분류 실험을 수행한 결과 속성 순서 최적화 후에 이전보다 향상된 예측율을 보였으며 또한 다층 신경망, k-최근접 이웃 등을 이용한 다른 모델보다 더 높은 예측율을 보였다.

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An Efficiency Management Scheme using Big Data of Healthcare Patients using Puzzy AHP (퍼지 AHP를 이용한 헬스케어 환자의 빅 데이터 사용의 효율적 관리 기법)

  • Jeong, Yoon-Su
    • Journal of Digital Convergence
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    • v.13 no.4
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    • pp.227-233
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    • 2015
  • The recent health care is growing rapidly want to receive offers users a variety of medical services, can be exploited easily exposed to a third party information on the role of the patient's hospital staff (doctors, nurses, pharmacists, etc.) depending on the patient clearly may have to be classified. In this paper, in order to ensure safe use by third parties in the health care environment, classify the attributes of patient information and patient privacy protection technique using hierarchical multi-property rights proposed to classify information according to the role of patient hospital officials The. Hospital patients and to prevent the proposed method is represented by a mathematical model, the information (the data consumer, time, sensor, an object, duty, and the delegation circumstances, and so on) the privacy attribute of a patient from being exploited illegally patient information from a third party the prevention of the leakage of the privacy information of the patient in synchronization with the attribute information between the parties.

A Study on Mother's Perception of Uncertainty and Nursing Need Concerning Child's Hospitalization (입원아동어머니의 질병에 대한 불확실성의 인지와 간호요구)

  • Kim, Hyun-Ju;Kim, Mi-Hyun;Kim, Yeo-Kyung;Yu, Mi-Bok;Oh, Jin-A
    • Korean Parent-Child Health Journal
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    • v.10 no.2
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    • pp.136-146
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    • 2007
  • Purpose: The purpose of this study was to provide fundamental data in ensuring a high quality of nursing needed by hospitalized child's mother through research of the mother's perception of uncertainty and nursing need concerning child's hospitalization. Method: 173 hospitalized child's mothers at G hospital in Busan are questioned. The tools used in this study are PPUS(Parent's Perception of Uncertainty Scale) and the nursing need of hospitalized children's mother. The data was analyzed by SPSS/PC program. Results: 1) The perception of total uncertainty for the hospitalized child's mother showed average 2.37 and the nursing need showed very high level, 3.37. 2) The perception of uncertainty in accordance with general character of the hospitalized child's mother shows non significant difference 3) Significant correlation indicated between the perception of uncertainty of hospitalized children's mother and nursing need. Conclusion: It is to be desired to prepare a program which can raise the level of perception developing a method that is able to practically assess and manage the level of perception of hospitalized children's mother.

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Exploration of Structural Relations on Health Behavior Related to Particulate Matter: Focused on Multi-Dimensional Health Locus of Control, Perceived Susceptibility and Severity, and Health Behavioral Intention (미세먼지 관련 건강행동에 대한 구조적 관계의 탐색: 다차원 건강통제소재, 지각된 취약성과 심각성 및 건강행동의도를 중심으로)

  • Joo, Jihyuk
    • Journal of the Korea Convergence Society
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    • v.8 no.11
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    • pp.413-421
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    • 2017
  • This study explored relationships between health perception and behavior of Korean relevant to particulate matter(PM) as PM in the atmosphere getting worse. To investigate the relationship in the personal hygiene dimension, we analysed the structural relationships among multi-dimensional health locus of control, perceived susceptibility and severity, and health behavior intention. Except internal among three tendencies of multi-dimensional health locus of control, chance and powerful other had an effect on perceived susceptibility and severity, respectively. Perceived susceptibility and severity also had a positive effect on the intention. Thus, to facilitate PM-related disease prevention, timely and reliable information should be supplied with the solution for lessening damage from PM, and then training for internalizing locus of control should be encouraged through eliminating fear and uncertainty. Finally, we discussed suggestions for future study.

Prognostic Modeling of Metabolic Syndrome Using Bayesian Networks (베이지안 네트워크를 이용한 대사증후군의 예측 모델링)

  • Park Han-Saem;Cho Sung-Bae;Lee Hong Kyu
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.07b
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    • pp.292-294
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    • 2005
  • 대사증후군은 당뇨병, 고혈압, 복부 비만, 고지혈증 등의 질병이 한 개인에게 동시에 발현하는 것을 말한다. 미국에서는 $25\%$ 이상의 성인이 대사성 증후군인 것으로 알려져 있으며, 경제 여건의 향상 및 식생활 습관의 변화와 함께 최근 우리나라에서도 심각한 문제가 되고 있다. 한편 불확실성의 처리를 위해 많이 사용되고 있는 베이지안 네트워크는 사람이 분석 가능한 확률 기반의 모델로 최근 의학 분야에서 지식 발견, 데이터 마이닝을 위한 도구로 유용하게 사용되고 있다. 본 논문에 서 는 대사증후군을 예측하는 문제를 다루며, 베이지안 네트워크와 의학 지식을 이용한 대사증후군의 예측 모델을 제안한다. 제안하는 모델을 통해 1993년의 데이터를 가지고 1995년의 상태를 예측하는 분류 실험을 수행하였으며, 실험 결과 다층 신경망, k-최근접 이웃 등의 분류기 보다 높은 $81.5\%$의 예측율을 보였다.

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Uncertainty and Nursing Need According to Illness Phases in Cancer Patients (질병단계별 암 환자의 불확실성과 간호 요구도)

  • Lee, Mi-Sun;Kim, Hee-Ju;Suh, Soon-Rim
    • Korean Journal of Adult Nursing
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    • v.20 no.1
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    • pp.1-9
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    • 2008
  • Purposes: This study examined uncertainty and nursing need according to illness phases(phase I, II, III) in cancer patients, and investigated relationships between uncertainty and nursing need. Methods: A cross-sectional descriptive study was conducted with a sample of 121 adult cancer patients treated in two hospitals. Results: As for the total score, the uncertainty was not significantly different across the subgroups by illness phase. As for the subscale score, however, two sub-scales of the uncertainty were different across the subgroups. 'The unpredictability' was highest in illness phase I and II groups, while 'the lack of information' was highest in the illness phase III group. Nursing need as the total score was not significantly different across the subgroups by illness phase. However, all subscale scores of the nursing need were significantly different across the subgroups. Educational need was highest in the illness phase I group; physical and emotional needs were highest in the illness phase III group. Uncertainty and nursing need were not related to each other at any illness phase. Conclusion: The results suggest that nursing need and uncertainty may change across illness phases. Clinicians need to consider this pattern in caring for cancer patients.

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Maternal Uncertainty in Childhood Chronic Illness (만성질환아 어머니의 아동질병으로 인한 불확실성 경험)

  • Park Eun Sook;Martinson M.I.
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.207-220
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    • 1998
  • The purpose of this study was to build a substantive theory about the experience of the maternal uncertainty in childhood chronic illness. The qualitative research method used was grounded theory. The interviewees were 12 mothers who have cared for a child who had chronic illness. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of nine months. The data were analyzed simutaneously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. The 34 concepts were identified as a result of analyzing the grounded data. Ten categories emerged from the analysis. The categories were lack of clarity, unpredictability, unfamiliarity, negative change, anxiety, devotion normalization and burn-out. Causal conditions included : lack of clarity, unpredictability, unfamiliarity and change ; central phenomena : anxiety, being perplexed ; context. seriousness of illness, support ; intervening condition : belief action/interaction strategies devotion, overprotection ; consequences : normalization, burn-out. These categories were synthesized into the core concept-anxiety. The process of experiencing uncertainty was 1) Entering the world of uncertainty, 2) Struggling in the tunnel of uncertainty, 3) Reconstruction of the situation of uncertainty. Four hypotheses were derived from the analysis : (1) The higher the lack of clarity, unpredictability, unfamiliaity, change, the higher the level of uncertainty (2) The more serious the illness and the less the support, the higher the level of uncertainty. (3) The positive believes will influence the devoted care and normalization of the family life. Through this substantive theory, pediatric nurses can understand the process of experiencing maternal uncertainty in childhood chronic illness. Further research to build substantive theories to explain other uncertainties may contribute to a formal theory of how normalization is achieved in the family with chronically ill child.

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Perceived Uncertainty and Rearing Attitude of Mothers with Chronically ILL Children (만성질환아 어머니의 질병에 대한 불확실성 정도와 양육태도)

  • Park Eun Sook
    • Child Health Nursing Research
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    • v.2 no.2
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    • pp.5-18
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    • 1996
  • The purposes of this study were to measure the degree of perceived uncertainty and to identify the rearing attitudes of mothers with chronically ill children, and to examine the relationship between the perceived uncertainty and the rearing attitude of these mothers. The subjects of this study consisted of 133 mothers with chronically ill children, registered at 2 university hospitals in Seoul. Data was collected from April 1 to May 31, 1996. The Parents' Perception of Uncertainty Scale(28-item 4 point scale) and the Maternal Behavior Research Instrument (49-item 5 point scale) were used. Data was analyzed by Cluster analysis, ANOVA MANOVA and t-test. Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high (Mn 2.48). The degree of perceived uncertainty by the four components slightly differed unpredictability(2.72), lack in clarity(2.58), vagueness (2.52) and lack of information(2.04) . The degree of perceived uncertainty of mothers with ill children revealed to be influenced significantly by the age of the ill children, duration of illness after the diagnosis, and the experience of hospitalization. 2. Among the rearing attitudes : moderatlely high affective(Mn 3.98) and resrictive(Mn 3.58) attitudes of mothers toward their ill children were identified. Mothers tend to give positive evaluations of their childrens' behaviors (Mn 3.38) and less rejection(Mn 2.81). 3. Mothers' rearing attitude were correlated with the degree of perceived uncertainty in illness ; mothers in the Low Perceived Uncertainty Group (Mn 1.99) revealed the highest affective (Mn 4.08), the lowest resrictive(Mn. 2.72) attitudes and tendency to give positive evaluations of their childrens' behaviors (Mn 3.54) compared to the High Perceived Uncertainty Group(Mn 3.26) and Moderate Perceived Uncertaity Group(Mn 2.57). 4. The degree of perceived uncertainty, the duration of illness after the diagnosis and the experience of hospitalization revealed to be significantly influential to the rearing attitude of mothers with chronically ill children. From the above results, it can be concluded that predicting and controlling mothers' uncertainty are necessary for improved, efficient nursing interventions and normal growth & development of the chronically ill children.

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