• 의학교육논단
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• 제18권1호
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• pp.26-37
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• 2016

This study aimed to investigate the relationship among the cultural disposition, morality, and psychological health of medical students to determine how these factors might relate to curriculum planning in medical education. Data was collected from a total of 186 medical students. The questionnaire used included the individual cultural disposition scale, the symptom checklist-90-revised, and the defining issues test. To evaluate individual cultural disposition, we classified students into four categories-low, individual, collective, or mixed cultural disposition-using individualism/collectivism and vertical/horizontal dimensions. We found that those who were younger and in earlier academic years had higher collectivism than individualism and the males had higher individualism than the females. There was no difference in morality or psychological health by the students' sex, age, or academic year. Horizontal collectivism and moral judgment showed a statistically significant correlation (r=0.150, p<0.05), as did stage 6 morality and symptoms of damaged psychological health (r=-0.156, p<0.05). Other than these relationships, no significant correlations between cultural disposition and morality or between morality and psychological health were found. Cultural disposition did have correlations with various aspects of psychological health; specifically, the highest correlation coefficients were found in the relationships between phobic anxiety and horizontal individualism, psychoticism and vertical collectivism, and hostility and horizontal collectivism. The four cultural disposition categories showed relationships not with morality but with psychological health factors including depression, anxiety, hostility, and phobic anxiety. We hope the results of this study can be used to improve the curriculum of medical education.

• Safety and Health at Work
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• 제8권2호
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• pp.130-142
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• 2017

Background: Osteoarthritis of the knee is considered to be related to knee straining activities at work. The objective of this review is to assess the exposure dose-response relation between kneeling or squatting, lifting, and climbing stairs at work, and knee osteoarthritis. Methods: We included cohort and case-control studies. For each study that reported enough data, we calculated the odds ratio (OR) per 5,000 hours of cumulative kneeling and per 100,000 kg of cumulative lifting. We pooled these incremental ORs in a random effects meta-analysis. Results: We included 15 studies (2 cohort and 13 case-control studies) of which nine assessed risks in more than two exposure categories. We considered all but one study at high risk of bias. The incremental OR per 5,000 hours of kneeling was 1.26 (95% confidence interval 1.17-1.35, 5 studies, moderate quality evidence) for a log-linear exposure dose-response model. For lifting, there was no exposure dose-response per 100,000 kg of lifetime lifting (OR 1.00, 95% confidence interval 1.00-1.01). For climbing, an exposure dose-response could not be calculated. Conclusion: There is moderate quality evidence that longer cumulative exposure to kneeling or squatting at work leads to a higher risk of osteoarthritis of the knee. For other exposure, there was no exposure dose-response or there were insufficient data to establish this. More reliable exposure measurements would increase the quality of the evidence.

• 가정∙방문간호학회지
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• 제15권2호
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• pp.67-74
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• 2008

Purpose: We analyzed the need for home care services and awareness of U-healthcare in nurses of the Catholic Parish Home Care Center to link the ubiquitous health care system and the home care. Methods: We recruited 46 nurses from a home care center in the catholic parish of the C medical center from April 4th to June 8th, 2007. Results: The highest needs were 'assessment and diagnosis of the problem', 'management of hypertension & diabetes patients', 'counseling of the patient', and 'counseling of major caregiver and family problems'. Therapeutic nursing showed the highest needs in bedsore care. Nurses want hospital medical records available through the ubiquitous health care system. Conclusion: Home care services are supported from the agency, with high needs in assessing and diagnosing the problem, counseling, and managing of hypertension & diabetes patients. Education and public relations efforts on the U-healthcare system should improve system awareness.

• 가정∙방문간호학회지
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• 제14권1호
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• pp.31-41
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• 2007

Purpose: This study was designed to evaluate the effect of home care nursing intervention with parenteral hydration and IV anti-emetic therapy on distress, nutritional status, anxiety, depression and QOL in gynecologic cancer patients who were undergoing combination chemotherapy. Methods: Quasi-experimental design was used to test the intervention. Changes of result variables were measured to evaluate effects of the intervention. variables consisted of serum lab results(auto analytic equipment for lab), symptom distress Scale(McCorkle & Young, 1978; Song et al., 2000), nutritional status(body weight, circumference of upper arm, serum protein, serum albumin, oral intake per day), anxiety(Spielberger, 1972; Kim & Shin, 1978), depression(Zung, 1965; Kim, 1995) and QOL(Padilla et al., 1983; Lee & Jo, 1996). Subjects were selected among gynecologic cancer patients(EG 15 patients and CG 15 patients) by convenient sampling. Data collection was done from June to Nov. in 2000. Data were analyzed by Chi-test and Mann-whitney U test using SPSS Win 10.0. Result: Hypothesis 1, the EG receiving this intervention equals to lab test(Hb & ANC, GOT & GPT, BUN & Cr) the CG, was supported(u=69.50 p=.074; u=94.50, p= .455; u= 89.50, p= .339; u=106.50, p= .803; u=75.00, p= .119; u=97.50, p= .523). Hypothesis 2, the EG has less symptom distress than the CG, was also supported(u=43.50, p= .004). Hypothesis 3, the EG has higher nutritional status than the CG, was partially supported on daily oral intake (u=59.00, p= .025). Hypothesis 4, the EG has less anxiety than the CG, was rejected(u=86.50, p= .280). Hypothesis 5, the EG has less depression than the CG, was rejected(u=203.50, p= .228). and the last hypothesis 6, the EG has higher QOL than the CG was supported (u=51.50, p= .011). Conclusion: Home care nursing intervention undergone in this study was found to be effective to reduce patients' symptom distress and to improve their oral intake and QOL.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.293-299
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• 2020

Objective: The goal of the present study was to investigate the rate of chromosomal aneuploidies in surplus embryos after sex determination at the cleavage stage. Then, the same chromosomal aneuploidies were evaluated in blastocysts after extended culture. Methods: Sixty-eight surplus embryos were biopsied at the cleavage stage and incubated for an additional 3 days to allow them to reach the blastocyst stage. The embryos were reanalyzed via fluorescence in situ hybridization (FISH) to examine eight chromosomes (13, 15, 16, 18, 21, 22, X, and Y) in both cleavage-stage embryos and blastocysts. Results: Although the total abnormality rate was lower in blastocysts (32.35%) than in cleavage-stage embryos (45.58%), the difference was not significant (p=0.113). However, when we restricted the analysis to autosomal abnormalities, we observed a significant difference in the abnormality rate between the cleavage-stage embryos (44.11%) and the blastocysts (17.64%, p=0.008). A higher rate of sex chromosomal abnormalities was also observed in cleavage-stage embryos (29.4%) than in blastocysts (14.70%, p=0.038). Conclusion: The data indicated that embryo biopsy should be conducted at the blastocyst stage rather than the cleavage stage. The results also emphasized that examination of common chromosomal aneuploidies apart from sex selection cycles can be conducted in the blastocyst stage with the FISH method.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1717-1723
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• 2016

Background: This study assessed parental experiences with chemotherapy-induced alopecia among children with cancer treated at an Indonesian academic hospital. Materials and Methods: Fifty parents of childhood cancer patients were interviewed using semi-structured questionnaires. Results: The moment that hair fell out was the moment that parents (84%) had to admit their child had cancer. Alopecia was a traumatizing painful experience (46%). Active strategies to hide alopecia, mainly hats, were used by 66% of children, while 34% never covered their bald head. If money had not been an issue, 40% would use another strategy. Alopecia made children limit outdoor daily activities (78%) and engagement with others (60%). Significantly more children from high-educated (95%) than low-educated (60%) parents received sympathy from other people (P=0.012). Significantly more Christian (29%) than Muslim (0%) families confirmed that alopecia lowered the quality of life (P=0.046). Most parents (82%) had no prior plans about alopecia management, yet for significantly more girls (26%) than boys (0%) such plans existed (P=0.044). Parents received most information about alopecia from other parents (66%). Parents (92%) needed more alopecia education from doctors. Of all school-attending children, 53% were bullied and 47% did not want to attend school due to alopecia. Significantly more high-educated than low-educated families received pity from teachers and pupils (94% vs. 0%, P=0.004), and acceptance by pupils (81% vs. 0%, P=0.021). Conclusions: Alopecia is a severe, far-stretching side-effect of chemotherapy with physical, psychological and social consequences for children and parents. Parents should be better informed about occurrence and impact of alopecia. Extra attention is required to facilitate children's return to school. Healthcare providers should facilitate optimal supportive care through open dialogue and provision of educational m aterials for parents, children and their community.

• 대한예방한의학회지
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• 제16권3호
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• pp.89-105
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• 2012

Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

• 가정∙방문간호학회지
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• 제12권2호
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• pp.63-86
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• 2005

Purpose: This study is a descriptive research which is designed to investigate hospitalized patients' intent to use home care nursing according to the types of medical security. Method: This researcher surveyed 236 patients who were hospitalized at B medical center located in Busan,. Data were collected from Sep. 1 to Nov. 30, 2005 using a questionnaire survey, medical records, face-to-face interviews and observations. Collected data were analyzed in terms of frequency, percentage, mean and standard deviation through $x^2$-test and t-test under SPSS WIN 10.0 Program. Result: Out of the total subjects, 59.3% were medical aid clients and the remaining 40.7%, health insurance ones. The hospitalized period and frequency of the former group were 38.0 days and 4.0 times, respectively, while those of the latter, 37.7 and 3.4. When home care nursing clients were examined using a given classification device, it was found that out of the total 236 subjects, 205(86.9%) were needed to receive home care nursing, 121, medical aid and the other 84, health insurance. 24.0% of medical aid clients heard about home care nursing ever before, lower than 39.3% of health insurance clients. 43.8% of the former clients said cost for home care nursing was high while, 47.6% of the latter group responded expense for the nursing intervention was low. 30.6% of medical aid clients had intent to use home care nursing, lower than 47.6% of health insurance clients. 71.7% of those patients whose monthly income was 99 million won or below had no intent to use home care nursing, higher than 62.5% of those who were 100 million or over in monthly income(p<.05). 76.4% of those clients who had no nursing provider intented to use home care nursing, higher than those who had nursing provider(p<.05). Concerning contents of home care nursing, 85.1% of medical aid clients needed education, training and counseling while, 77.4% of health insurance aids wanted medication and injection. Conclusion: In conclusion, the use of home care nursing by medical aid clients should be promoted through improving conditions for home care nursing in terms of expense, family and residence and making public relations about activities and contents of the home care nursing.

• 부모자녀건강학회지
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• 제7권2호
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• pp.121-132
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• 2004

Purpose: This study aimed to develop a breast feeding program for mothers of premature infants. The program was applied and its effect was evaluated on stress, knowledge and breastfeeding behaviors of premature infant mothers. Method: This study employed a one group pre- and post-test quasi-experimental design. The data were collected from 17 participants from August 15 to October 24, 2004, at a N1CU at D University Medical Center located in Susan, Korea. Data were analyzed by means of frequency, SD, and t-test using SPSS version 10. Result: After the program, participants significantly showed a greater level of knowledge than before the program (t=-5.750, p=.000). No statistically significant differences in stress level scores were found (t=1.453, p=.153). The breastfeeding practice rate was 94.1%: Conclusion: This educational program using a handbook and video had a positive effect on increasing knowledge and practice of breastfeeding among premature infant mothers. It is suggested that this study be replicated with a larger sample size to compare group responses.

• Clinical Endoscopy
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• 제55권6호
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• pp.801-809
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• 2022

Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.