• Journal of muscle and joint health
• /
• v.19 no.3
• /
• pp.373-382
• /
• 2012

Purpose: The purpose of the study was to compare levels of health-related quality of life (HRQOL) between fallers and non-fallers among community-dwelling elderly people. Methods: A cross-sectional comparative study was conducted with the secondary analysis of 2,067 elderly people registered in S-Gu Visiting Health Care Program in Seoul, South Korea. Participants were 206 fallers and 206 non-fallers who were age- and sex-matched with fallers. HRQOL was measured by SF-8 including physical component summary (physical HRQOL) and mental component summary (mental HRQOL). Results: There were more people in the faller group having more than or equal to three chronic diseases (p<.001), living in multiplex houses (p=.004), and being dependent by the activities of daily living (ADL) (p=.001) and instrumental ADL (IADL) levels (p<.001) than those in the non-faller group. Fallers had higher levels of depression than non-fallers (p<.001). Moreover, fallers had significantly lower levels of both physical HRQOL (p<.001) and mental HRQOL (p=.001), after adjusting for number of chronic diseases, ADL, IADL, depression, healthcare insurance, and living environment. Conclusion: Among the community-dwelling elderly people, falllers had lower levels of HRQOL than non-fallers, and such a difference remained even after the adjustment for covariates. Factors that underlie the different susceptibility to HRQOL need to be explored.

• Journal of muscle and joint health
• /
• v.27 no.1
• /
• pp.12-21
• /
• 2020

Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x² test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

• Journal of muscle and joint health
• /
• v.14 no.2
• /
• pp.118-126
• /
• 2007

Purpose: The purpose of the study was to examine the relationship between the level of pain and depression in middle-aged women with chronic low back pain. Method: A descriptive correlational research design was utilized. The participants were middle-aged women who visited two back pain clinics in Wonju from October, 2006 through February, 2007. A total of 195 low back pain patients agreed to participate in this study, and data from 177 were analyzed. Data was collected using a questionnaire which included Visual Analogue Scale (VAS), Center Epidemiology Studies Depression Scale(CES-D), and general characteristics. Descriptive statistics, t-test, ANOVA and Pearson correlation coefficients were utilized in the analysis. Results: The mean score for chronic low back pain as measured by the VAS was 4.99 (SD 2.41). The average score for depression as measured by the CES-D was 22.00 (SD 10.18). There was a significant relationship between the level of pain and depression (r=.372, p<.001). Conclusion: Nurses need to take into consideration depression of middle-age women with chronic low back pain for assessment and intervention. In the future, developing a strategy for integrating intervention of pain-control and depression will be needed in nursing care for middle-aged women with chronic low back pain.

• Journal of muscle and joint health
• /
• v.15 no.1
• /
• pp.62-72
• /
• 2008

Purpose: There has been a need to integrating the self-help program for arthritis with the Tai Chi for arthritis(SHTCA). The purpose of this study was to develop and to examine the effect of SHTCA for arthritis applying the nine movement Tai Chi. Method: This study was designed the pre-post test, quasi-experimental design. A total 47 participants were recruited in W-city in Korea, an experimental group(26) and a control group(21) at pre-test, but after the eight weeks the composition of the groups were changed to 22 experimental group and 15 control group. The experimental group participated in the SHTCA once a week for eight weeks. SHTCA program consisted of understanding of the arthritis, contracting of the promise, exercise for muscle strength and joint flexibility and the nine movements of Tai Chi exercise. The measures used to examine the effect of the SHTCA were shoulder flexibility, back flexibility, grasping power, balance, abdominal obesity rates, perception of health status, and EQ-5D standardized five dimensions, mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Results: At The completion of the eight weeks of SHTCA applying the nine movement Tai Chi, the experimental group reported a significance in a number of variables compared to those of the control group: the right shoulder flexibility(p=.018), left shoulder flexibility(p=.031), right grasping power(p=.014), left grasping power(p=.024), the perception of health status(p=.005) and abdominal obesity rates(p=.027). Conclusion: This SHTCA applying the nine movement Tai Chi would be helpful on right shoulder flexibility, left shoulder flexibility, right grasping power, left grasping power, abdominal obesity rates and the perception of health status for arthritis patients.

• Health Policy and Management
• /
• v.2 no.2
• /
• pp.194-220
• /
• 1992

In recent years there has been a rapid influx of high cost MRI equipment into Korea. This diffusion has raised concerns about the changes it will bring for the health care utilization. Therefore, the purpose of this study is to identify socio-economic characteristics of MRI uses in Korea. A structured questionnaire was designed for this purpose, and 1, 091 users were surveyed at the 35 MRI units of 33 hospitals during a week, sometimes March 1992. The study reveals that high cost technology such as MRI, CT scanner is so prevalent in Korea. This is particularly the case in metropolitan areas. Among others, Seoul has the highest percentage of MRI equipment, 51.05%, Pusan 12.10% and Kwangju 11.9%. Unfortunately, most high cost technology equipments are foreign products. Thus, hospitals with such a high cost technology have difficulties in maintenance of the equipment. The average performance of MRI equipment has declined from 10.2 cases per day in 1988 to 7.16 cases in March 1992. Due to the rapid increase, the performance of MRI equipment seems to be deterioration. Male usere are dominant in the case of MRI use. The utilization rate has positively increased with the rise of educational level of users. The same is true for the level of income; the MRI utilization rate by income level shows that it is negatively proportional to income, which indicates that the poor have difficulties in the use of high cost technology. Particularly, the cost of MRI is so high that ordinary patients are unable to pay for it. For example, 86.3% of respondents have answered that the cost is too high even though they are insured by health insurance. This is the first empirical study on the use status of MRI. The information obtained in this study is sufficient to maintain that the Korean health insurance programme is urgently in need of improving the insurance benefit schemes. The easiest way to do this is to include provision of high cost technology service into the benefit package.

• Health Policy and Management
• /
• v.22 no.4
• /
• pp.561-578
• /
• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• Korean Journal of Hospice Care
• /
• v.5 no.2
• /
• pp.64-74
• /
• 2005

Purpose : This study is non-equivalent control group pre-post design attempted to see 'The effect of spiritual nursing intervention on the meaning of life and spiritual distress of the terminal cancer patients.' Method : The data collection was performed from June to October, 2004. The subjects were 41 terminal cancer patients of one general hospital in Jeon Ju city. They are formed two groups, 20 experimental group and 21 control group. Experimental treatment provided spiritual nursing intervention 3 times per a week, the mean 45 minutes each, for 4 weeks for experimental group with the contents of therapeutical use of oneself, use of bible, use of hymn, use of prayer, depend on the priest in the spiritual need assessment of 6 kinds. Study tools was used the thing which Kim(1990) developed about purpose inspection of life which Crumbaugh(1968) developed to measure the meaning of life. The measure of spiritual distress was used the tool which Kim(1990) developed, spiritual nursing intervention was developed by researcher of this thesis. Data was analyzed by descriptive statistics of real number, percentage, the mean etc. and x2-test, t-test, ANCOVA. Result: The 1st hypothesis, 'spiritual the meaning of life score in the experimental group, who received the spiritual nursing intervention, will be higher than the control group who did not receive it' was supported(F=157.09, P=0.000) The 2nd hypothesis, 'spiritual distress score in the experimental group, who received the spiritual nursing intervention, will be lower than the control group who did not receive it' was supported(F=36.48, P=0.000) Conclusion: Spiritual nursing intervention was verified as an effective program to improve the meaning of life and decrease spiritual distress for the terminal cancer patients. Thus, it was confirmed with an effective nursing intervention which helps them in order to spend the rest time of life meaningfully and meet the peaceful death.

• Clinical Nutrition Research
• /
• v.5 no.4
• /
• pp.279-289
• /
• 2016

The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery.

• Journal of Radiation Industry
• /
• v.9 no.2
• /
• pp.91-102
• /
• 2015

The iridium disc, generally used in industrial radiography, is examined to find the fracture morphology and fine particles remaining on the shear blank surface. Randomly selected 1,200 discs were observed under a scanning electron microscope tilted more than $45^{\circ}$. Fracture surfaces are classified into three groups: (1) surface fall-out, (2) fracture on the edge and (3) multi-step brittle fracture, which shows the mutual relationship between the fracture morphology and remaining particles. Fracture particles were removed by cleaning the discs in a ultrasonic bath with acetone and collected at the bottom. Removed number of the particles were counted for each different group of fracture surfaces. Followings are conclusions: (1) About 80.5% of discs (966/1,200), have sound plastic shear surfaces with particles remained. (2) About 2% discs accompany surface fall-out's having large particles tens of ${\mu}m$, which is stable not to be pulled out even after the considerably long time of ultrasonic cleaning. (3) About 5% discs contain the fractures on the edge and the particles are removed thoroughly within 30 minutes. (4) 234 discs out of 1,200 discs have multi-step fracture surfaces whose particles never removed in a short period of time but come out very slowly. Such a disc having multiple-step fracture is attributed to the promate cause to the 'leaker'. It is noted here that the discs having mutiple-step fractures should be treated separately with special care, and it is need to study how to treat them.

• Journal of Korean Medical Science
• /
• v.33 no.53
• /
• pp.341.1-341.11
• /
• 2018

Background: The converging epidemics of tuberculosis (TB) and end-stage renal disease (ESRD) have generated a significant public health burden, however, previous studies have been limited to a small number of patients. This nationwide cohort study aimed to assess the rate of developing active TB among patients receiving dialysis for ESRD. Methods: The Korean national health insurance database was used to identify patients receiving dialysis for new-onset ESRD during 2004-2013, who were propensity score matched to an equivalent number of non-dialysis subjects from the general population. The incidences of active TB in the ESRD and control cohorts were calculated for 2004-2013, and multivariable Cox proportional hazards model was used to evaluate the ESRD-related risk of active TB. Results: During 2004-2013, 59,584 patients received dialysis for newly diagnosed ESRD. In the dialysis and control cohorts, 457 (0.8%) and 125 (0.2%) cases of active TB were detected, respectively. Patients with ESRD were associated with a significantly higher risk of active TB compared to the controls (incidence rate ratio, 4.80). The ESRD cohort had an independently elevated risk of active TB (adjusted hazard ratio, 4.39; 95% confidence interval, 3.60-5.37). Conclusion: We found that patients receiving dialysis for ESRD had an elevated risk of active TB. These results highlight the need for detailed and well-organised guidelines for active TB screening among patients with ESRD.