• Journal of Preventive Medicine and Public Health
• /
• v.57 no.3
• /
• pp.212-222
• /
• 2024

Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

• Nutrition Research and Practice
• /
• v.18 no.4
• /
• pp.534-543
• /
• 2024

BACKGROUND/OBJECTIVES: Studies on the impact of dietary fiber intake on kidney stones are few, and their results were controversial. This study aimed to explore the association between dietary fiber intake and kidney stones in the nationally representative population of the USA. SUBJECTS/METHODS: This cross-sectional research included 8,588 participants from the National Health and Nutrition Examination Survey, 2011 to 2018. Information regarding dietary fiber intake was obtained from a 24-h recall survey. Participants were categorized into different dietary fiber intake tertiles according to the average of 2 days of dietary recall data. The outcome was self-reported kidney stones. After adjusting for the traditional risk factors, a multivariate logistic regression model was used to examine the association between dietary fiber intake and kidney stones. RESULTS: Eight hundred seventy-two participants had kidney stones. The weighted prevalence (SE) of kidney stones in the lowest tertile, medium tertile, and highest tertile of dietary fiber intake was 11.8% (0.8%), 10.3% (0.8%), and 9.1% (0.8%), respectively. After adjusting for age, sex, race and ethnicity, education level, smoking status, alcohol consumption, physical activity, body mass index, hypertension, diabetes, dyslipidemia, daily water intake, chronic kidney disease stage 3-5, and total energy intake, participants with the highest tertile of fiber intake had a significantly lower risk of kidney stones (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.48-0.95) compared to those in the lowest tertile. Every 5 g/day increment in dietary fiber intake was associated with a significant decrease in risk of kidney stones (OR, 0.90; 95% CI, 0.83-0.98). CONCLUSION: An increase in dietary fiber intake was associated with a lower risk of kidney stones, suggesting adults should be encouraged to maintain an adequate dietary fiber intake to prevent the development of kidney stones. Our results provide evidence to formulate nutrition management strategies for the prevention of kidney stones.

• Journal of the Korean Society of School Health
• /
• v.11 no.2
• /
• pp.203-215
• /
• 1998

The purpose of this study is to inquire into the degree of health promotion activity in university students, and to find out the relationship between self-efficiency and health promotion behavior, Thus, we can offer basic data for developing an educational method or program for health promotion. For this research, data was collected from university men and women through a questionnaire from February 18 to March 20, 1998. A measuring instrument was based on lating reviews of health promotion behavior in chronic disease protection, perceived self efficiency, demographic factors, biological factors, and circumstatial factors. The content validity of the instrument was authenticated by two professors of nursing, and reliability was confirmed by 'cronbach' (${\alpha}^{\prime}$ after mortifying content through a pre-test on 30 students. 475 persons were analyzed in terms of average, percentage, t-test, ANOVA, Pearson's Correlation Coefficient, and Multiple Stepwise Regression by 'SPSS-PC'. The analyzed data is as follows: 1. Higher self-efficiency, as a cognitive-perceptual factor, has a beneficial effect on health promotion behavior (r=.479, p=.000). The result of analyzing the differences among a low group, a middle group, a high group in terms of self-efficiency reveals that the relationship between self-efficiency and health promoting behavior is meaningful. 2. The degree of health promoting behavior is 3.26 out of 6. Other figuresrelating to health promoting behavior, are as follows. self-actualization area (4.62), interpersonal area (4.60), stress management area (4.01), nutrition area (3.68), responsibility of health area (3.11), liquid and cigaret area (2.85), and exercise area (2.33). 3. The degree of self-efficiency was 6.81 out of 10. Other figures relating to self-efficiency are as follows. interpersonal area (7.89), self-actualization area (7.84), liquid and cigarette area (7.72), exercise area (6.88), stress management area (6.84), responsibility of health area (6.35), and nutrition area (6.34). 4. The different lerels of health promoting behavior according to a subject's general factos are following: age (p=0.003), sex (p=0.000), health concern of parents (p= 0.000), taking health programs (p=0.007), case history of familes (p=0.048). Health promoting behavier is also positirely affeted by the following: higher age, social sciences focus, religion, living the relatives', and the higher health concerns of parents. 5. The difference of self-efficiency according to a subject's general factors is positirely affected by sex (p=.008), the health concerns of parents (p=.004), body indexes (p=.001), and the higher health concerns of parents. 6. As the result of analyzing major factors, the most powerful factor appears to be self-efficiency, 26.6% of health promoting behavior. Suggestions: 1. Results of this study point to self-efficiency as a major factor in the health promoting behavior of university students. It is crucial, therefore, to develop a health program to promote self-efficiency and to study how to promote prerention of certain diseases. 2. That health promoting behavior appears low in this study shows that health education should be taken into the university class, with a focus on the daily life of students as its goal.

• Journal of the Korean Society of School Health
• /
• v.1 no.1
• /
• pp.160-177
• /
• 1988

This study is an analysis of the teachers' health problems that focuses on the frequencies and types of their visiting to school clinics and the management of health-related problems. The participants for this study are consisted of 1,650 teachers employed at 30 public schools in the Seoul area. Data for the study came from diagnostic records for 1986, the results of a questionaire-type survey conducted between June 20th and of the same year an from other documents recorded by school nurses. The main results of this study are as follows: 1. The teachers' health problems. a) According to health diagnosis records, 6.1 % of all teachers had a health problem. Liver-related ailments topped the list, followed by circulatory and diabetic problems. b) The survey data had 71.9 % of the respondents indicating that trey suffered from some health problem. The most frequent response concerned respiratory problems, followed by gastro-intestinal and nervous system problems. c) A check of clinic utilization records revealed that the main reasons for visiting are concerned with fatigue (30.5 %), gastro-intestinal(18.7 %) and respiratory(18.2 %) ailments. These three categories accounted for 67.4 % of total use. 2. Frequencies of their visiting to school clinics 40.5 % of the teachers indicated that they have visited the school clinic. And 62.0 % visited it with a self-diagnosed ailment and 15.3 % utilized the facility after a problem had been detected in a health examination. Clinics were visited a total of 1,458 times which breaks down to 0.9 times per month per teacher. For a patient, the figures are 2.2 times on the average with a range from 1 to 19. 3. Health management problems a) Of those respondents. 53.4 % stated that they didn't have enough time to consult about their health problems and diagnose their disease b) Also, 47.3 % of the respondents indicated that school nurses should give health counsels and health education. c) When questioned about improvements in the current system, the teachers placed importance on the prevention and management of chronic diseases (35.2 %) and pre- and posteducation concerning periodic health examinations In conclusion, the following points must be considered: First, school administrators need to pay more attention to the health problems of the teachers. Second, school nurses should be more active in managing a health program for teachers. Finally, education and training for nurses should be continually upgraded so that they can dispense proper and timely care for teachers.

• Research in Community and Public Health Nursing
• /
• v.5 no.2
• /
• pp.109-129
• /
• 1994

Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

• Journal of muscle and joint health
• /
• v.1 no.1
• /
• pp.1-30
• /
• 1994

Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

• Journal of Nutrition and Health
• /
• v.53 no.2
• /
• pp.141-154
• /
• 2020

Purpose: Atopic dermatitis (AD), a typical chronic disease in children, is an allergy disease that is highly associated with food. Thus, attention to food intake is needed to prevent and manage it. Therefore, we analyzed differences in food and nutrient intakes depending on AD status in under 12-year-old children. Methods: A total of 2,690 participants were enrolled in this study from the combined 2013-2015 Korea National Health and Nutrition Examination Survey. Subjects were divided into an AD group and normal group (non-AD group). General characteristic, food and nutrients intakes, and prevalence of insufficient and excessive nutrient intake were analyzed using χ² test and regression analyses. The AD odds ratio (OR) for insufficient and excessive nutrient intakes was analyzed using multiple logistic regression analyses. Results: Food and nutrient intakes were not significantly different between the AD and non-AD groups. However, the ratio of calcium intake to recommended nutrient intake was about 70% in both groups, which can be attributed to the overall lack of calcium intake among Korean children. There were no differences in energy or nutrient intakes between the groups, but compared with Korean Dietary Reference Intakes for Koreans, the appropriate intake ratios of fat and vitamin C in the AD group were higher than those in the non-AD group. The AD OR decreased when fat was consumed at above appropriate levels and vitamin C was consumed at lower or excess levels. Conclusion: In children, AD may be related to the nutrient intake ratio of fats and vitamin C, and we speculate that these results were affected by dietary restrictions for AD management.

• The Korean Journal of Pain
• /
• v.29 no.3
• /
• pp.172-178
• /
• 2016

Background: This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods: A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results: 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group ($17.24{\pm}13.50$ and $9.91{\pm}6.47$ respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95-19.87, P = 0.05). Conclusions: This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.6
• /
• pp.474-481
• /
• 2011

Background: Chronic obstructive pulmonary disease (COPD) is characterized by air low limitation, which is one of the leading causes of mortality worldwide. There have been many studies on survival rates in the world literature, but there have been few reports regarding the survival rate in Korean patients with COPD. Acute exacerbation is regarded as a risk factor for mortality in patients with COPD. The purpose of this study was to investigate the survival rate and the effect of acute exacerbations on the survival rate of Korean patients with COPD. Methods: A total of 502 COPD patients who were diagnosed on the basis of history and lung function tests were enrolled in this study. The frequency of acute exacerbations, body mass index (BMI), C-reactive protein (CRP) and pulmonary hypertension were analyzed. Results: The 3- and 5-year survival rates were 98% and 83%, respectively. The median survival time was 78 months. The median survival time was 55 months in 322 patients with one or more acute exacerbations. The 3- and 5-year survival rates were significantly lower in the 322 patients with one or more acute exacerbations than in those without any. The mortality rate was significantly higher in patients with CRP>3 mg/L than in those with CRP ${\leq}3$ mg/L (p<0.005); it was significantly higher in patients with pulmonary hypertension than in those without it (p<0.01). Conclusion: Because the 5-year survival rate is 83% in Korean patients with COPD, the management of stable patients with COPD should focus on the prevention of acute exacerbations.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.17
• /
• pp.7567-7573
• /
• 2015

Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Meta-analysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6%, pulmonary complications 94.5% and ocular complications 89.9%. The incidence of various cancers in victims exposed to mustard gas was 1.7% worldwide where the rate was 2.2% in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90% and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures for populations exposed to this agent.