• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.167-173
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• 2018

Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.

• Korean Journal of Adult Nursing
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• v.23 no.2
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• pp.111-122
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• 2011

Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.

• Korean Journal of Adult Nursing
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• v.21 no.2
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• pp.199-211
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• 2009

Purpose: The purpose of this study was to develop a program for anger management based on self-efficacy. Methods: In this study, four types of approaches to enhance anger control were developed; 1) a role play for vicarious experiences; 2) an assertive training for anger expression; 3) a 30-minute long education program & a 20-minute long telephone call coaching for verbal persuasion; and 4) a booklet for anger management and self care behaviors. One group pretest-posttest design was used for evaluating the program. Study subjects were 6 cancer patients undergoing chemotherapy. The group were received a 4-week intervention, 60 ~ 90 minutes a day weekly, and measured the variables at baseline, 4 weeks later. Anger-in, anger-out, and anger-control were measured by STAXI-K. Data was analysed by Wilcoxon using SPSS/WIN 12.0 program. Anger situation was analysed according to primary anger-thoughts and secondary anger-thoughts based on cognitive theories of anger. Results: The program for anger management consisted of a role play, assertive training, education, telephone call coaching and a booklet. The program revealed significantly less Anger-in (Z = -1.997, p = .046), anger-out (Z = -2.207, p = .027). No difference, however, was found in anger control (Z= -1.826, p=.068). Conclusion: This evaluation suggested that more assertive training and longer intervention may be needed to maximize anger control.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.132-143
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• 2007

Purpose: The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF. Methods: Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires. Results: Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group. Conclusion: By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.

• Korean Journal of Adult Nursing
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• v.24 no.2
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• pp.130-138
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• 2012

Purpose: The purpose of this study was to verify the effects of gum chewing temporalis muscle exercise on masticatory discomforts after craniotomy. Methods: Data collection was performed from July 10 to October 24, 2008. Forty participants who were treated with elective craniotomy were enrolled in this study. Twenty participants in the exercise group were given a gum chewing exercise protocol for five days and twenty participants in the control group received usual postoperative care only. All the participants were examined on the first, third and fifth postoperative day regarding the masticatory pain score, mouth opening range, and satisfaction with mastication. Collected data were analyzed using t-test, $x^2$-test and repeated measures ANOVA. Result: Masticatory pain of experimental group was significantly lower than the control group ($p$ <.001). Mouth opening range and satisfaction with mastication of experimental group were significantly improved in experimental group compared with the control group ($p$ <.001). Conclusion: The gum chewing temporalis muscle exercise after craniotomy is a useful intervention to reduce masticatory pain and to improve mouth opening range, recovery rate of mouth opening range and satisfaction with mastication.

• Korean Journal of Adult Nursing
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• v.16 no.1
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• pp.146-155
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• 2004

Purpose: The Purpose of this study was to explain the effects of aromatherapy massage on the preoperative anxiety of hemorrhoidectomy patients, and to provide the effective and holistic nursing care to them. Method: The research design was a nonequivalent control group non-synchronized design. The data were collected during the period from November 1 to November 30, 2003 at K-Hospital in Seoul. The subjects were fifty patients who were to have a hemorrhoidectomy under general anesthesia. They were assigned to two groups, 25 subjects to the experimental group and 25 subjects to the control group. The State Anxiety Inventory tool was used to measure state-anxiety on all patients the day before surgery. Systolic and diastolic blood pressure, and pulse rate were measured on the day before surgery and the preoperative period. The experimental group received aromatherapy massage on the hand with lavender oil. Data were analyzed by $x^2$ test, independent t-test, paired t-test. Result: 1. Hypothesis 1, that the level of preoperative state-anxiety of the experimental group who received aromatherapy massage would be lower than that of the control group who did not received aromatherapy was supported(p=.047). 2. Hypothesis 2was that the Physiological index of the preoperative anxiety of the experimental group who received aromatherapy would be lower than that of the control group who did not received aromatherapy. The 1st subhypothesis that "the level of the preoperative systolic and diastolic blood pressure of the experimental group would be less than that of the control group" was not supported. Conclusion: Aromatherapy massage can be regarded as a partially effective nursing intervention that relives the preoperative anxiety of surgical patients and stabilizes vital signs.

• Journal of Korean society of Dental Hygiene
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• v.11 no.6
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• pp.843-852
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• 2011

Objectives : The aims of the study were to examine perceived oral malodor and self-reported need for oral and dental care among patients receiving oral prophylaxis services and provide guidelines for developing educational programs(toothbrushing method and tongue cleaning) for oral hygiene and oral malodor prevention. Methods : The survey was administered to a sample of 462 receiving voluntary oral prophylaxis service in a dental laboratory at the J School of Public Health in Korea. The subjects were asked a range of questions related to the degrees of perceived oral malodor and concern for oral health status, as well as their demographic information and need for oral and dental treatment. Univariate analyses using Chi-square and T-test with a P-value of .05 were performed using SPSS Version 12.0 for Windows. Results : 1. Male participants reported "moderately concerned for bad breath and smell" and "I don't care bad breath and smell" 39.1% and 26.2% respectively, while more female participants were concerned for oral malodor. "moderately concerned for malodor" and" highly concerned for malodor" 41.1% and 28.5%(p<.05). a significant difference among age groups was found. 19% of young adults (less than or equal to 29 years of age) reported "highly concerned for bad breath and smell" while 36.4% of older adults (greater than or equal to 50 years of age) reported "highly concerned for bad breath and smell"(p<.05). 2. 12 non-smoking participants (3.7%) and 15 smoking participants (10.8%) reported that they have perceived bad breadth and smell (p<.05). 3. Smoking participants reported a higher degree of need for oral malodor treatment than that of non-smoking participants 88.5% and 82% respectively(p<.05). 4. The participants who did regular toothbrushing more than 3 times a day reported "no malodor", 77 % as compared to 66.7% of the participants who did regular toothbrushing 2 times a day. Toothbrushing 2 times a day reported either "moderate malodor" or "sever malodor"(p<.01). Participants with more frequent toothbrushing reported less oral and breath odor as compared participants with less frequent toothbrushing. Conclusions : The study suggested that there is a need to oral prophylaxis for prevention and toothbrushing and tongue cleaning method oral malodor care and oral health status.

• Korean Journal of Social Welfare
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• v.46
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• pp.319-348
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• 2001

The primary purpose of this study is to examine the buffering effect of social welfare services on the relationship between the level of older persons' impairment and burden experienced by the family caregivers. It also assessed the level of caregiving burden as well as the effect of both older person's impairment and the characteristics of the caregivers on burden. The survey data collected from 150 community residing family caregivers was used for analyses. Findings are as follows. First, the caregivers are more burdened in the deterioration of mental health, scarce time for oneself, and the suffering of social life than in other areas of burden. Second, the more severe the physical and the mental impairment of the elder, the more burden the caregivers experience. The caregivers' characteristics such as the worse mental health, the lower level of attachment to the elder, the longer caregiving hours are also related to the higher level of caregiving burden. Third, the caregivers' use of adult day care and respite care services buffer the relationship between the level of impairment of older persons and the caregiving burden. However, social work counselling, visiting nurse, homemaker services do not have such buffering effects. Among informal support, instrumental support buffers the relationship between the elder's physical impairment and burden, while emotional support buffers the relationship between the elder's mental impairment and burden. According to the results, implication for social welfare services and practice methods for the family caregivers was discussed.

• Journal of Agricultural Extension & Community Development
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• v.10 no.2
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• pp.153-166
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• 2003

The objective of this study is to explore the situations and extension roles for rural elderly welfare program in North Dakota, USA. With a growing older population, aging has become an important issue for extension. Services for rural elderly available in North Dakota were adult day care, home health care, senior insurance counseling, nutrition and medication assistance programs, support groups, legal assistance, meals on wheels, nursing homes and more. With a growing older population, aging has become an important issue for extension. Extension provides programs and services for rural elderly. This study was conducted by literature review. First, many rural elderly Americans are actively engaged in volunteer work and have made substantial contributions to their communities. Second, extension educators from interdisciplinary areas should work together to develop programs. Extension programs can include intergenerational programs to help younger generations learn about the issue. Third, extension can collaborate with other agencies and groups to offer support groups. Offering educational programs is a key to empowering older people. Fourth, elderly residents may be the only increasing natural resource for volunteering in general, and for participation in community improvement in particular. Fifth, extension educators should be proactive in working with agencies to provide social access and in helping older people be actively engaged in their lives, especially in rural areas.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.28-35
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• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.