• Journal of Yeungnam Medical Science
• /
• v.40 no.1
• /
• pp.49-57
• /
• 2023

Background: Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool. Methods: This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results. Results: The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively. Conclusion: QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.

• Journal of Yeungnam Medical Science
• /
• v.40 no.1
• /
• pp.91-95
• /
• 2023

Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

• Physical Therapy Korea
• /
• v.30 no.1
• /
• pp.32-40
• /
• 2023

Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL-BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

• The Journal of Korean Medicine
• /
• v.43 no.4
• /
• pp.102-130
• /
• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.

• Journal of People, Plants, and Environment
• /
• v.22 no.3
• /
• pp.309-319
• /
• 2019

This study was conducted to investigate the effects of watching a virtual reality (VR) forest video on stress reduction in adults. Experiments were performed in an artificial climate chamber where temperature, humidity and illumination were controlled. To cause stress in subjects, the subjects were asked to multiply two digit numbers by one digit numbers for two minutes. The subjects then watched a VR forest video for five minutes. During the experiment, the heart rate variability (HRV) and heart rate (HR) of subjects were continuously measured for evaluating their physiological state. After measuring the baseline and watching a VR forest video, their psychological state was evaluated using the profile of mood state (POMS), semantic differential (SD) method, and positive affect and negative affect schedule (PANAS). The results of physiological evaluation after watching a VR forest video showed a decrease in the stress index and HR, an increase in the activity of the parasympathetic nervous system, and the standard deviation of normal to normal RR intervals (SDNN). The results of psychological assessment confirmed that watching a VR forest video induced "comfort", "natural", and "soothed" feelings in subjects. In addition, watching a VR forest video decreased "tension-anxiety (T-A)", "depression-dejection (D)", "anger-hostility (A-H)", "fatigue (F)", "total mood disturbance (TMD)", and increased "vigor (V)" compared to the base line, and decreased "negative affect" and increased "positive affect." These results indicate that watching a VR forest video decreases adults' stress index, stabilizes physiological state, and has a positive impact on psychological state. The findings of this study can serve as a basis for providing forest welfare services to people in the blind spots of forest welfare, and can lay a foundation for the adoption of VR, one of the technologies of the fourth industrial revolution in forestry.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.24 no.2
• /
• pp.119-128
• /
• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• Korean Journal of Psychosomatic Medicine
• /
• v.21 no.1
• /
• pp.11-17
• /
• 2013

Objectives : This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. Methods : Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. Results : The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age(55.8%) were significant explanation variables for health related quality of life. Conclusions : The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.

• Journal of The Korean Association For Science Education
• /
• v.33 no.7
• /
• pp.1367-1384
• /
• 2013

The purpose of this study was to develop a Science Academic Emotion Scale for Elementary Students. To make a scale, authors extract a core of 14 emotions related to science learning situations from Kim & Kim (2013) and literature review. Items on the scale consisted of 14 emotions and science learning situations. The first preliminary scale had 174 items on it. The number of 174 items was reduced and elaborated on by three science educators. Authors verified the scale using exploratory factor analysis, confirmatory factor analysis, inter-item consistency and concurrent validity. The second preliminary scale consisted of 141 items. The preliminary scale was reduced to seven factors and 56 items by applying exploratory factor analysis twice. The seven factors include: enjoyment contentment interest, boredom, shame, discontent, anger, anxiety, and laziness. The 56 items were elaborated on by five science educators. The scale with 56 items was fixed with seven factors and 35 items to get the final scale by applying confirmatory factor analysis twice. Except for Chi-square and GFI (Goodness of Fit Index), other various goodness of fit characteristics of the seven factors and 35 items model showed good estimated figures. The Cronbach of the scale was 0.85. The Cronbach of seven factors are 0.95 in enjoyment contentment interest, 0.81 in boredom, 0.87 in shame, 0.82 in discontent, 0.87 in anger, 0.77 in anxiety, 0.81 in laziness. The correlation coefficient was 0.59 in enjoyment contentment interest, 0.54 in anxiety, 0.42 in shame, and 0.28 in boredom, which were estimated using the Science Academic Emotion Scale and National Assessment System of Science-Related Affective Domain (Kim et al., 1998). Based on the results, authors judged that the Science Academic Emotion Scale for Elementary Students achieved an acceptable validity and reliability.

• Korean Journal of Psychosomatic Medicine
• /
• v.8 no.1
• /
• pp.88-97
• /
• 2000

Objectives : This study was aimed to investigate the emotional state and personality factors of patients with vitiligo, and the impacts of clinical characteristics. Methods : Twenty one patients with vitiligo and 20 normal controls were studied. Beck Depression Inventory(BDI), Spielberg's State and Trait Anxiety Inventory(STAI) and Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, t-test, Oneway ANOVA, Mann-Whitney U test and Pearson's correlation test were used. Results : The Results were as follows. 1) The comparison of total score of BDI, state anxiety and trait anxiety between the patients with vitiligo and normal controls were not significantly different. 2) In first-stratum source traits of 16-PF, normal control group was significantly higher than the patients with vitiligo in H-factor(Boldness) and I-factor(Tender-mindedness). In second-stratum source traits of 16-PF, there was no significant difference between the patients with vitiligo and normal control in all factors. 3) According to sex, the comparison of total scores of BDI, STAI between male and female patients with vitiligo were not significantly different. In the comparison of 16-PF, female patients were higher than male patients in I-factor only. 4) As according to age(under and over 30 years of age), the comparison of total scores of BDI, STAI between patients over 30 years of age and under 30 years of age were not significantly different. In the comparison of 16-PF, patients over 30 years of age were higher than patients under 30 years of age in E-, G-, L-, M-, Q2-, Q3-, IND-, SUP-, and CRE-factor. 5) As according to the presence of progression of vitiligo and the presence of visible lesion, the comparison of total scores of BDI, STAI and 16-PF were not significantly different. 6) There were no significant correlation between the duration of the vitiligo and BDI, STAI-S, STAI-T, and 16-PF. Conclusions : There were no significant difference between patients with vitiligo and normal controls on the emotional state and personality characteristics. But patients with vitiligo were more bolder and tender-minded than normal controls on 16-PF. The author propose that methods of treatment to resolve problems of the interpersonal relations will be helpful.

• Sleep Medicine and Psychophysiology
• /
• v.8 no.1
• /
• pp.45-51
• /
• 2001

Objectives: The experience of traffic accident is a kind of the psychosocial stressors to person. The traffic accident-related patients may show the psychophysiologic hyperarousal. So we examined the differences of psychophysiologic response between patients with and without the memory of experienceing a traffic accident. Methods: Twenty-four traffic accident-related patients were divided into two groups according to ther memory of a traffic accident. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory, and Hamilton Rating Scales For Anxiety and Depression. Heart rate, electrodermal response (EDR), and electromyographic activity (EMG) were measured by biofeedback system, and systolic and diastolic blood pressure by automated vital sign monitor during baseline, task, and rest periods. We utilized script-driven imagery technique as a stressful task. The patients listened to the script describing their own traffic accident experience and were instructed to imagine the event during the task period. Statistically analytic data were obtained from the differences of psychological and psychophysiologic data between two groups. Results: The memory group did not show significantly higher EDR than the none memory group, but showed higher tendency during baseline, imagery, and rest periods. The memory group showed significantly lower EMG than the none memory group during rest period. However, there were no differences in other psychophysiologic reponses between the two groups. Conclusion: Our results showed that the memory group had higher tendency in autonomic arousal level such as electrodermal response than the none memory group. We suggest that physicians need to minimize repetitive imagery of traffic accident (reexperience), and decrease the autonomic hyperarousal in the treatment of traffic accident-related patients.