• Journal of Korean Academy of Nursing
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• v.42 no.5
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• pp.699-708
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• 2012

Purpose: This study was designed to test structural equation modeling of the quality of life of pre-dialysis patients, in order to provide guidelines for the development of interventions and strategies to improve the quality of life of patients with Chronic Kidney Disease (CKD). Methods: Participants were patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic factors, social support, nutritional status, physical factors and biobehavioral factors and quality of life were collected between March 4 and March 31, 2011. Results: In the final analysis 208 patients were included. Of the patients 42% were in a malnourished state. Anxious or depressed patients accounted for 62.0%, 72.6%, respectively. Model fit indices for the hypothetical model were in good agreement with the recommended levels (GFI=.94 and CFI=.99). Quality of life in pre-dialysis patients with CKD was significantly affected by demographic factors, social support, nutritional status, physical factors and biobehavioral factors. Biobehavioral factors had the strongest and most direct influence on quality of life of patients with CKD. Conclusion: In order to improve the quality of life in pre-dialysis patients with CKD, comprehensive interventions are necessary to assess and manage biobehavioral factors, physical factors and nutritional status.

• Archives of Obesity and Metabolism
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• v.1 no.2
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• pp.66-73
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• 2022

Obesity is an increasing public health and medical issue worldwide. It has been associated with several comorbidities, including diabetes, cardiovascular disease, stroke, and cancer. Chronic kidney disease (CKD) is another important comorbidity of obesity. Other major causes of CKD include hypertension and diabetes. However, the association between obesity and CKD is often overlooked. Among patients with CKD, patients with obesity were more vulnerable to have rapid kidney function decline than that of those with normal weight. Additionally, CKD is more prevalent among patients with obesity. These aggravations are induced through multiple mechanisms, specifically metabolic impairment of obesity and mechanical burden because of increasing intraabdominal renal pressure. Furthermore, the inflammation and lipotoxicity, caused by obesity, are critical in the CKD aggravation in patients with obesity. To prevent this, all adult patients with obesity are tested for CKD. The workup includes the estimated glomerular filtration rate and regular follow-up. Step-wise management is required for patients with obesity with CKD. Prompt reduction and management of obesity effectively delay CKD progression among patients with obesity and CKD. Therefore, weight loss is a core management for patients with obesity and CKD. Based on several studies, this article focused on the association between CKD and obesity, as well as the diagnosis and weight management of patients with obesity and CKD.

• Korean Journal of Health Education and Promotion
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• v.32 no.1
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• pp.33-44
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• 2015

Objectives: This study examined the effects of optimism and repressive coping on psychopathological symptoms and health management behavior in college students with chronic physical diseases. Methods: We conducted a survey on optimism, repressive coping, psychopathological symptoms, and health management behavior to patients with a chronic physical disease. Results: The results showed that both of optimism and repressive coping were related to fewer psychopathological symptoms. In addition, the repressive coping were related to fewer risk taking behaviors. Conclusion: Based on the results of this study, it is possible that how to well protect their psychological physical health to patients with a chronic physical disease.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.510-515
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• 2006

Background : Although 17% of Korean adults over the age of 45 years have chronic obstructive pulmonary disease (COPD), there is only limited data on the cause of death in COPD patients in Korea. Therefore, this retrospective study was performed to examine the cause of death in COPD patients at a referral hospital in Korea. Methods : The medical records of 28 deceased patients diagnosed as COPD in Asan Medical Center from January to December 2003 were reviewed patients had died in Asan Medical Center and 16 patients had died outside the hospital. The Korean National Statistical Office confirmed 88 deceased patients out of 1,078 patients diagnosed as COPD in Asan Medical Center in 2003. After excluding those with tuberculous destroyed lung, bronchiectasis, and lung cancer, 28 COPD patients were evaluated. Results : The causes of death were pulmonary disease including pneumonia in 16 patients (57%), cardiac disease in 5 patients (18%), sudden death in 3 patients (11%), and other causes in 4 patients (14%). The cause of death was pulmonary disease in 83% (10 out of 12 patients) and 38% (6 out of 16 patients) of patients who died in Asan Medical Center and outside the center, respectively (P=0.05). The cause of death was pulmonary disease in 43% of patients with $FEV_1$ more than 50 % of the predicted value and in 55% of patients with $FEV_1$ less than 50 % of the predicted value (P=0.89). Conclusion : Pulmonary disease is the leading cause of death in COPD patients in Korea.

• Kidney Research and Clinical Practice
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• v.36 no.1
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• pp.48-57
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• 2017

Background: Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients. Methods: CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years). Results: The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%], P < 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr, P = 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L, P < 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m, P < 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (${\beta}=0.742$, P < 0.001), triglyceride levels (${\beta}=2.034$, P < 0.001), estimated glomerular filtration rate (${\beta}=0.316$, P = 0.001), serum albumin (${\beta}=1.386$, P < 0.001), alanine aminotransferase (${\beta}=0.064$, P = 0.029), and total bilirubin (${\beta}=-0.881$, P = 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183; P = 0.029) even after adjusting for multiple confounding factors. Conclusion: Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.

• Annals of Surgical Treatment and Research
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• v.95 no.6
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• pp.324-332
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• 2018

Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

• Journal of agricultural medicine and community health
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• v.37 no.4
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• pp.246-257
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• 2012

Objectives: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. Methods: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using ${\chi}^2$-test and multiple logistic regression. Results: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. Conclusions: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking.

• Journal of Home Health Care Nursing
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• v.23 no.2
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• pp.139-146
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• 2016

Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

• Journal of Korean Biological Nursing Science
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• v.15 no.3
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• pp.107-114
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• 2013

Purpose: This study was aimed to describe the level of medication adherence and to identify the impact of cognitive function and self-efficacy on medication adherence of elderly patients with chronic disease. Methods: The descriptive study included 303 patients over 65 years with chronic diseases from two medical centers in Cheonan city. Data were collected from July to November 2011. A questionnaire including questions on the Korean version of mini-mental state examination (MMSE-K), self-efficacy and medication adherence were completed by the subjects. Data were analyzed using the SPSS/WIN 20.0 program. Results: The mean score of medication adherence was $1.4{\pm}1.6$. In univariate analysis, exercise (t=2.85, p=.005), type of disease (F=3.91, p=.001) and self-efficacy (r=-.57, p<.001) were the significant factors related to medication adherence. Linear regression analysis demonstrated that self-efficacy (${\beta}$=-.57, p<.001) was a significantly associated factor with medication adherence. Self-efficacy explained about 33% of the total variance of the medication adherence in elderly patients. Conclusion: The results suggest that self-efficacy to medication can be a facilitator to medication adherence in elderly patients. However, these results indicate that there remains much work to be done in identifying other predictors of medication adherence of elderly patients with chronic diseases.

• 대한근관절건강학회:학술대회논문집
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• 1997.05a
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• pp.134-146
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• 1997

Sixty-nine articles were reviewed to understand the depression in patients with rheumatoid arthritis. Among these articles, forty seven were the studies that dealt with depression in rheumatoid disease, nineteen studied the depression in patients with other chronic disease or in normals, and three were the studies that compared the depression in the patients with rheumatic disease and in the other subjects. Specifically, the articles were analyzed (1) to determine whether the patients with rheumatic arthritis were more depressed than normal population or subjects with other chronic diseases ; (2) to test whether the measurement problems exit ; (3) to identify the disease related, personal, psychologic, and demographic variables to affect the depression and (4) to identify the nursing interventions which improve the depression in rheumatoid arthritis. Based upon these results, some suggestion were made for future research and practice.