• Title/Summary/Keyword: Attending Patient

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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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A Long Term Follow Up Two Cases of Lesch-Nyhan Syndrome Pink Diaper (Lesch-Nyhan 증후군 장기 추적관찰: 분홍 기저귀)

  • Jae Young Kim;Wung Joo Song;Bong-Ok Kim;Harvey L. Levy;Sook Za Kim
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.24 no.1
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    • pp.26-36
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    • 2024
  • Lesch-Nyhan syndrome (LNS) is an Clinical symptoms can range from mild to severe depending on residual enzyme activity and genetic mutations. In Korea, 27 cases of LNS have been reported. We report the results of an 11-year comparative follow-up of two cases of children who visited because of pink diapers, one who died from LNS with no residual enzymes and one case with partial residual enzymes. Case 1: During follow-up, seizures, developmental delay, and regression were observed. The boy experienced insomnia and severe constipation. He exhibited self-mutilating behavior, a grand mal seizure, scoliosis with severe spasticity, truncal hypotonia, choreoathetoid movement, and ataxia. After prolonged emaciation, staghorn calculi, and recurrent pneumonia, the patient died suddenly at the age of 11 years. Genetic testing revealed a hemizygous HPRT1 variant (c.151C>T (p.Arg51Ter)). Uric acid level was 10.5 mg/dL (normal range: ~3.5-7.9) and HPRT activity 0.02 nmol/hr/spot (10-23.8 nmol/hr/spot). Case 2: During follow-up, the patient remained underweight. He has normal intelligence attending primary school. Self-mutilation symptoms were not observed. Regular renal ultrasonography did not reveal urolithiasis. The patient had a hemizygous HPRT1 variant (c.35A>C (p.Asp12Ala)). Uric acid level and HPRT activity were 11 mg/dL and 0.56 nmol/hr/spot. Pink diapers after the neonatal period and severe protein aversion, neurological problems, and kidney stones, differentiation for LNS is necessary. When suspected, serum uric acid levels, HPRT enzyme activity, and molecular biological tests may be helpful in predicting the prognosis of LNS.

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The Attitude of the Bereaved Family Attending a Bereavement Memorial Service (사별가족모임과 관련된 사별가족 태도 연구)

  • Jung, In-Soon;Shim, Byoung-Yong;Kim, Young-Seon;Lee, Ok-Kyung;Han, Sun-Ae;Shin, Ju-Hyun;Lee, Jong-Ku;Hwang, Su-Hyun;Ok, Jong-Sun;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.143-151
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    • 2005
  • Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

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A Study on The Actual Condition and Demand Assessment of First Aid Education on Higher Grade Students in Elementary School (초등학교 고학년생의 응급처치 교육실태 및 교육 요구도)

  • Cho, Keun-Ja;Choi, Eun-Sook;Lee, Hyeun-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.175-189
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    • 2007
  • Background and Purpose : Higher grade students in elementary schools are most adequate subjects for first aid training. The purpose of this study was to assess first aid education and needs of higher grade students in elementary schools. Method : The subjects of this study were 183 higher grade students from 8 elementary schools. Data were collected by the questionnaire during the period from March 19 to April 13, 2007. The data were analyzed through frequency, Cronbach's ${\alpha}$, Independent Two samples t-test, One Way ANOVA by SPSS win 12.0. Result : 1. It showed that 78.1%(143 persons) of sujects answered that they learned first aid. 65% of sujects learned in the school(65%). 61.2% of sujects were taught by health teachers. 36.7%(67 person) of subjects was educated using practice with demonstration including lecture. Learned contents were action at emergency(50.8%), CPR(36.6%), splint (33.9%). 2. It showed that 90.2%(165 persons) of subjects answered that first aid and CPR education are necessary. Also 74.9%(137 persons) of subjects answered that will be educated first aid and CPR if opportunities is given. The 53.3%(73 persons) of subjects wanted teaching method using practice with demonstration including lecture. 3. The total mean showed $2.29{\pm}.48$ in needs of first aid education by 3 points Likert scale. Needs of first aid education was ranked Heimlich maneuver($2.41{\pm}.65$), splint and bandaging($2.38{\pm}.59$). Priority of intensive training showed patient assessment(38.0%) and CPR(19.7%) in first, splint and bandging(22.6%), CPR(21.9%) and Heimlich maneuver(21.9%) in second. 4. The needs assessment of first aid education showed statistically significant differences according to teaching method(F = 2.563, p = .025), education necessity yes or no(F = 2.474, p = .015), attending future education yes or no(F = 2.253, p = .026). Conclusion : These results suggest that First aid education for higher grade students in elementary schools must be consisted of most adequate content and method based on current education condition and needs assessment.

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State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

  • Kim, Hyung Tae;Kim, Sae Young;Byun, Gyung Jo;Shin, Byung Chul;Lee, Jin Young;Choi, Eun Joo;Choi, Jong Bum;Hong, Ji Hee;Choi, Seung Won;Kim, Yeon Dong
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.287-295
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    • 2017
  • Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results: Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions: Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.

A Study of the Influence of illness on Body Image and Self Concept -Specifically in Children with Asthma- (만성 질환이 자아개념 (Self Concept)과 신체상(Body Image)에 미치는 영향 -천식 환아를 중심으로-)

  • 장효순
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.80-90
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    • 1982
  • This study was undertaken to determine the influence of a chronic disease on body image, and to show that body image is directly related to one's self concept. Body image is the concept of one's own body based on present and past perception, and is elated to one's self concept. Body image is a dynamic concept constantly changing throughout the life cycle but it changes greatly in illness, surgery, and accident. The child with a chronic disease experiences pain and immobilization due to illness and he/she experiences a strange environment in the hospital. illness often brings feeling of frustration and loss of self-esteem. Therefore this study was done to compare the body image of a child with a chronic disease(Asthma), with that of a normal healthy child, and to determine the relationship between the body image and self concept. The subjects in this study were 36 children being treated for asthma at the allergy clinic of Y University Hospital in Seoul (patient group) and 44 children attending elementary school in Kwanak Ku Seoul (normal healthy group). For the measurement of the body image, the researcher used Secord & Jourard's Body Cathexis Scale, and another scale which was constructed after reading about Osgood's Semantic Differential Method. For the measurement of the self concept, the researcher used Jacox & Stewart's Health Self Concept. The period for data collection was from October 7th to October 27th, 1982. The analysis of data was done by use of Percentage, t-test, Chi-square test, Pearson Correlation Coefficient and ANOVA, The results of the study were as follows: 1. The first hypothesis,“That the chronically ill (Asthma) child will have a more negative body image than the normal healthy child.”was supported. 2. The second hypothesis,“The more negative the body image, the lower the self concept.”was also supported. 3. The researcher failed to obtain statistically significant results in the analysis of the general characteristics which affect the body image except in the case of the older child as compare to the younger Child having a mole positive body image (r=.2751, r=.2481, p<.05). However it was found that, 1) Boy's have a more positive body image than girls (Mean=〔37.81, 141.09〕,〔37.00, 126.54〕), 2) The child who has been hospitalized has a more negative body image than the child who has never been hospitalized (Mean=〔33.25, 122.45〕,〔35.68, 129.93〕). 3) The younger the child when the disease is discovered and diagnosed, the more negative the body image (Onset of illness: Mean=〔31.44, 117.33〕,〔34.00, 103.50〕, 〔35.75, 140.38〕,〔36.33, 130.00〕, Time of Diagnosis: Mean=〔29.00, 117.33〕,〔33.89, 115.00〕,〔33.36, 124.93〕,〔37.10, 139. 20〕). In conclusion the chronically ill(.Asthma) child has a more negative body image than the normal healthy child, and the more negative the body image the lower the self concept. Therefore the concept of body image is useful in understanding the influences of chronic disease on body' image and self concept.

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Correlation Between Perceived Family Support and Self-Esteem of Middle Age Women with Degenerative MusculoSkeletal Diseases (퇴행성 근골격계 질환을 가진 중년여성이 지각한 가족지지의 자아존중감의 관계)

  • Kang, Kyung-Ja;Lee, Eun-Jin
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.5-24
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    • 2000
  • Middle age for women is one of the most important stages of the whole normal life span and has unique problems concerning the psychological and physical health, specifically degenerative musculoskeletal diseases. Therefore middle age women should prepare in order to lead a healthy and fruitful life as they enter/begin old age. As the population of middle age women increase, the demands of nurses who care for this age group also continue to glow. Nurses must be interested in this middle age group of women in Korea. This study was designed to identify the extent of family support and self-esteem of the middle age women with degenerative musculoskeletal diseases and the relationship between them and nurse's contribution to middle age women's health promotion that maintain and promote qualify of her life. The population of this study was 112 women aged 40-60, attending the out patient clinic one University Hospital and one Hospital, in Pusan. The data was collected from 1st August to the 30th of September, 1998 by using 36 items questionnaire. The instrument used for measuring family support was of Chai's(1983) FSS which was modified by Kang's(1984) Family Support Scale. And that for self-esteem was Rosenberg's(1965) Self-esteem Scale. The reliability of Chai's FSS and Rosenberg's instruments were tested by Cronbach's alpha and showed that they were 0.93 and 0.89 each respectively. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS computer program. The results of the study were summarized as follows : 1. The mean score of the perceived family support was $39.31{\pm}9.42$. 2. The mean score of the perceived self-esteem was $33.16{\pm}6.75$. 3. Statistically significant factors influencing the family support among sociodemographic variables was satisfaction of marriage(F=-3.069, p<0.003). 4. Statistically significant factors influencing the self-esteem among sociodemographic variables were age(F=3.992, p=0.000), education(F=2.260, P=0.026), housing (F=-1.987, P=0.049) and satisfaction of marriage(F=-2.305, P=0.023). 5. There was a significant correlation between family support and self-esteem (r=.621, p<.000). In conclusion, perceived the family support was important for middle age women to increase their self-esteem. Nurses should be aware of the necessity of family support in the supportive nursing of middle age women and should be able to make a plan to educate the family about supporting the wife/mother. The continuing study of the health promotion of middle age women to find out variables influencing middle age women' health must continue.

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Low Frequency of ETV6-RUNX1 (t 12; 21) in Saudi Arabian Pediatric Acute Lymphoblastic Leukemia Patients: Association with Clinical Parameters and Early Remission

  • Aljamaan, Khaled;Aljumah, Talal khalid;Aloraibi, Saleh;Absar, Muhammad;Iqbal, Zafar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7523-7527
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    • 2015
  • Background: Pediatric acute lymphoblastic leukemia (pALL) patients at King Abdulaziz Medical City represent a pure Saudi Arabian population. ETV6-RUNX1 positive pALL patients have good prognosis as compared to ETV6-RUNX1 negative counterparts. Therefore, frequencies of these two patient groups have a huge consideration in treatment strategies of pALL in a given population. Different geographical locations have been reported to have different frequencies of ETV6-RUNX1 ranging from 10% in Southeast Asia to 30% in Australia. Aim: Therefore, the objective of this study was to establish the ETV6-RUNX1 status of Saudi Arabian pALL patients and its association with clinical parameters and early remission. Materials and Methods: Clinical parameters and ETV6-RUNX1 status (using FISH technique) of pALL patients attending the Pediatric Oncology Clinic, King Abdulaziz Medical City, Riyadh from 2006 to 2011 were studied. Comparisons between ETV6-RUNX1 positive and negative groups were accomplished using chi-square test or Fisher's exact test. All statistical analyses were performed using SAS version 9.2 (SAS Institute, Inc., Cary, NC). Results: Out of 54 patients, 33 were male and 21 were females (ratio 1.57:1). B- and T-cell lineages were found in 47 (87%) and 7 (13%) patients respectively. Only 5 (9.3%) patients were ETV6-RUNX1 positive while 49(80.7%) were ETV6-RUNX1 negative. All ETV6-RUNX1 patients (100%) were of B-cell lineage and 80% (4/5) were in the 3-7 year age group. None of the ETV6-RUNX11 patients had ${\geq}5%$ blasts (no remission) at day 14 as compared with 9% in the ETV6-RUNX1 negative group (Figure 1). Conclusions: Frequency of ETV6-RUNX1 positive patients (less than 10%) in our pALL patients is much lower than reported for most European countries, North America, Australia and Japan while it is in accordance with ETV6-RUNX1 frequencies from Egypt (11.6%), Pakistan (10%), Spain (2%) and India (5-7%). This shows ethnic differences in genetics of pALL as well as higher frequencies of ETV6-RUNX1 positive pALL mostly in more industrialized countries, probably due to some industrial pollutants or westernized lifestyle.

A Study on Perceptions by College Students of Radiology about the Knowledge, Attitudes and Behaviors of Radiation Exposure Management (방사선과 대학생이 방사선피폭관리에 대한 지식, 태도, 행위에 관한 연구)

  • Yeo, Jindong;Ko, Inho;Kim, Hye-Sook
    • Journal of the Korean Society of Radiology
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    • v.9 no.2
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    • pp.79-99
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    • 2015
  • Participants of this study were students of radiology who were attending colleges or universities located in Daegu and Gyeongbuk. This researcher conducted a questionnaire survey of those students from Feb. 3rd to 21st, 2014. The findings of the study can be summarized as follows. 1. Concerning the knowledge of radiation exposure management, the respondents' scores were highest in two items, or 'Materials based on lead or concrete may shield X-rays' and 'The sexual gland is very sensitive to radiation' and lowest in the item which says' 'Occupational radiation exposure dose should not exceed 20mSv a year in average on a 5-year period basis'. 2. The participants' scores for the attitudes of radiation exposure management were higher in two items, or 'Health examination should be made regularly in relation to radiation exposure' and 'Those who work within the area of irradiation should wear protective clothes' and lowest in the item which says 'Radiation exposure dose should be regularly measured for the calibration of the radiation system'. 3. For the behaviors of radiation exposure management, the surveyed students showed highest scores in two items, or 'When irradiating the patient, the radiator should be behind the protective barrier(plate)' and 'It is needed to receive the education of radiation exposure management regularly' While, their score for a behavior described in the item saying 'Before using the radiation system, it is needed to check whether the machine works normally.

Clinical Evaluation of Surgical Treatment for Hemoptysis Patients (객혈환자의 외과적 처치에 대한 임상적평가)

  • 이성주;문승철
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1097-1104
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    • 1997
  • The expectoration of blood is always a fearful experience for the patient and a matter of grave concern to the attending physician, because it may be the warning sign of serious diseases. When such bleeding occurs, the possibility of its being due to pulmonary tuberculosis, bronchiectasis or carcinoma of the lung is promptly suggested. Nowadays, with the advance of modern diagnostic studies, differential diagnosis has become possible for the hemoptysis patients to have appropriate treatment. This evaluation is based on the review of 75 cases of patients whom we performed emergency open thoracotomies for 6 years from March 1992 to February 1997 in the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital. The mean age of the patients was 36.6 years old with a range from 19 to 68, and most prevalent age group was thirties. The most common underlying lung disease causin hemoptysis was tuberculosis(44%). Most accurate diagnostic study was bronchoscopy during hemoptysis(95 Vo) and right middle & lower lobe(17.3%) was the most common site of lesion. Lobectomy(50%) was the most frequent operative method and recurrent hemoptysis(31.6%) was the most common postoperative complication. But most of the patients(82.6%) were completely recovered by surgical treatment. Now we concluded that the proper management of hemoptysis was completed by surgical approach with definite diagnosis and supportive medication.

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