• 대한간호학회지
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• 제37권1호
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• pp.135-144
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• 2007

Propose: The purpose of this study was to help families decrease and alleviate the burden on family care-givers taking care of elderly patients. Method: Data was collected by a questionnaire from 100 family members who were registered in the department of home health care nursing at 4 hospitals of H University Medical Center from September 20 to October 25, 2005. The collected data was analyzed using Mean and Standard Deviation, Pearson Correlation Coefficient, t-test and One-Way ANOVA with the Duncan's test, and Stepwise multiple regression. Result: The average burden on family care-givers of elderly patients with chronic diseases was 3.31. The social burden was the highest(M=3.68), the lowest was the emotional burden(M=2.95). In ADL of elderly patients with chronic diseases, all 10 questions showed an average point above 2.50. The dependency level of going up and down the stairs was the highest(M=2.88). Conclusion: This research is necessary for the application of a plan in the social support system in order to reduce the burden on family care-givers who are taking care of elderly patients with a chronic disease.

• 대한간학회지
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• 제24권4호
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• pp.351-357
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• 2018

The advent of novel, direct-acting antiviral (DAA) regimens for hepatitis C virus (HCV) infection has revolutionized its treatment by producing a sustained virologic response of more than 95% with few side effects and no comorbidities in the general population. Until recently, ideal DAA regimens have not been available to patients with severe renal impairment and end-stage renal disease because there are limited data on the pharmacokinetics, safety, and efficacy of treatment in this unique population. In a hemodialysis context, identifying patients in need of treatment and preventing HCV transmission may also be a matter of concern. Recently published studies suggest that a combination of paritaprevir/ritonavir/ombitasvir and dasabuvir, elbasvir/grazoprevir, or glecaprevir/pibrentasvir successfully treats HCV infection in chronic kidney disease stage 4 or 5 patients with or without hemodialysis.

• 대한한방내과학회지
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• 제25권4호
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• pp.45-51
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• 2004

Background : Atopic Dermatitis is a chronic and recurrent skin disease. it is characterized as itch-scratch cycle and topical or systemic use of corticosteroids is required in western medicine. Though its effects on major symptoms are impressive, these treatments are prone to several side effects and tend to recur after months or years. So potential treatments have been actively studied in Estern medicine, especially Sasang constitutional therapy, which has fewer side effects. Objectives : The purpose of this study was to examine the effect of Sasang constitutional therapy on treating severe adult Atopic Dermatitis and preventing its recurrent symptoms. Methods : fifteen patients who had severe adult Atopic Dermatitis attended treatment of Sasang constitutional therapy and were followed up for one year. An oriental internal specialist first isolated Sasang constitution and a distinctive body type. Grading of Atopic dermatitis was measured by the guidelines offered by Rajka G. and Langeland T. Results : After treatment with Sasang constitutional therapy, the patients symptoms were improved and the mean Rajka and Langeland score reduced significantly from $7.73{\pm}0.79\;to\;3.4{\pm}10.91$. During the follow-up period of one year, the mean Rajka and Langeland score was $2.72{\pm}2.06$ which was lower than last treatment. Conclusions : The results of this study support Sasang constitutional therapy as an effective therapy for severe adult Atopic Dermatitis. Follow up data suggest that this Eastern medical approach is of greater clinical value than the western medical approach in the long term.

• 대한예방한의학회지
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• 제25권3호
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• pp.25-37
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• 2021

Objectives : To investigate the effectiveness of Korean Medicine services use on the all-cause mortality and incidence of Parkinson's disease(PD) in elderly patients with chronic disease based on the National Health Insurance Service Corhort Database (elderly), called as the NHIS-senior. Methods : This study was a retrospective cohort analysis conducted using the NHIS-senior. Patients with chronic diseases over 65 years old who were not diagnosed PD during 2007-2009 were identified. The case group was defined as patients who used both Korean Medicine and Western Medicine services and the control group consisted of patients who used Western Medicine service only. The all-cause mortality and incidence of PD was analyzed using the Cox proportional hazard model after a propensity score matching(PSM) with a 1:1 ratio. Results : After PSM, the cohort included 47,546 subjects (23,773 in the case group, 23,773 in the control group). Sex, age, comorbidity, severity of disability, and neurology medical service utilization were adjusted in both groups. The mortality was 0.668 times (95% C.I.: 0.646-0.690) lower in the case group than the control group, which was statistically significant (p<0.001). The incidence of PD was 1.051 times (95% C.I.: 0.962-1.148) higher in the case group than the control group, which was not statistically significant(p=0.272). Conclusion : It was not obvious that the use of both Korean Medicine service and Western Medicine services for prevention of PD is benefitial than using only Western Medicine. But it would be possible that using both Korean Medicine and Western Medicine services decreases the mortality than using Western Medicine alone.

• 한국보건간호학회지
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• 제9권2호
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• pp.52-68
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• 1995

This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

• 약학회지
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• 제54권6호
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• pp.455-460
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• 2010

We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.

• Tuberculosis and Respiratory Diseases
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• 제76권2호
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• pp.53-58
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• 2014

Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

• 셀메드
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• 제14권2호
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• pp.6.1-6.6
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• 2024

The prevalence of respiratory diseases is increasing due to social and environmental factors such as increased environmental pollution and air pollution, and among them, chronic obstructive pulmonary disease (COPD) in particular has a high mortality and morbidity rate worldwide. As a result, medical expenses are rapidly increasing, creating a social and economic burden. In response to this, there is a need to discuss ways to reduce the risk from diseases and manage them appropriately, and the most basic starting point in this process is how these chronic lung disease patients are treated in actual clinical settings and how to improve the quality of treatment. There is a need to look into whether there are effective drugs. Western treatment for chronic obstructive pulmonary disease is basically a disease in which the airway narrows, so bronchodilators are used to widen the bronchi, and corticosteroids and antibiotics are mainly used to relieve the inflammatory response in the lungs. However, since the mainly used Western medicine does not serve as a fundamental therapeutic drug and contains many side effects, there is a need for drugs that improve the quality of life of patients and are more effective in managing symptoms as symptomatic prescriptions. Therefore, Western and Oriental medicine treatments are needed. The purpose is to suggest better treatments through comparative analysis.

• Tuberculosis and Respiratory Diseases
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• 제68권3호
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• pp.125-139
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• 2010

Patients with chronic obstructive pulmonary disease (COPD) frequently complain of dyspnea on exertion and reduced exercise capacity, which has been attributed to an increase in the work of breathing and in impaired of gas exchange. Although COPD primarily affects the pulmonary system, patients with COPD exhibit significant systemic manifestations of disease progression. These manifestations include weight loss, nutritional abnormalities, skeletal muscle dysfunction (SMD), cardiovascular problems, and psychosocial complications. It has been documented that SMD significantly contributes to a reduced exercise capacity in patients with COPD. Ventilatory and limb muscle in these patients show structural and functional alteration, which are influenced by several factors, including physical inactivity, hypoxia, smoking, aging, corticosteroid, malnutrition, systemic inflammation, oxidative stress, apoptosis, and ubiquitin-proteasome pathway activation. This article summarizes briefly the evidence and the clinical consequences of SMD in patients with COPD. In addition, it reviews contributing factors and therapeutic strategies.

• 한국융합학회논문지
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• 제10권11호
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• pp.543-555
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• 2019

본 연구의 목적은 만성질환자의 공유의사결정에 대한 개념의 속성을 명확히 정의하기 위함이다. 개념분석의 절차는 Walker and Avant의 방법에 근거하여 학제간 융합적 분석을 시도하였다. 분석결과, 만성질환자의 공유의사결정의 속성은 자기돌봄 전문가로서 인정, 자기 결정권, 번복 가능한 협상, 환자중심 돌봄으로 정의되었다. 선행요인은 비슷한 치료방법 중 선택해야 할 필요성이 있는 상황, 의사결정 갈등, 환자, 가족, 의료제공자의 참여 의지, 충분한 시간과 기회이다. 만성질환자의 공유의사결정의 결과는 의사결정 갈등 감소, 환자결과와 만족도 및 삶의 질의 향상, 장기적인 환자의 자기관리 및 자기 효능감 향상, 질병을 수용하는 삶의 태도이다. 본 연구는 만성질환자의 공유의사결정에 대한 명확한 개념을 제공하고, 관련 간호중재 개발을 위한 이론적 근거 형성에 기여할 수 있을 것이며 만성질환자를 위한 공유의사결정 측정도구 개발 연구의 수행을 제언한다.