• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Korean Journal of Culture and Social Issue
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• v.15 no.3
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• pp.339-357
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• 2009

As quickly becoming an ageing society in Korea, this study aims to investigate how family caregivers' burden with demented patients and social supports are related to their health and quality of life, and the interaction of caregiving burden and social supports on caregivers' health and quality of life. The participants were 207 family caregivers (106 females) of demented patients lived in Seoul, Kyunggi, and Chungcheong areas, whose average of age were 51.62 ( SD=9.25). The psychological tests used in this research included the following: Multidimensional Caregiver Burden Inventory, Chon's Physical Symptom Questionnaire, Hahn & Jang's Perceived Health Inventory, Negative Affect Self-Statement Questionnaire, and the Korean Version of Cambell's Subjective Well-being Scale, Social Support Survey in Medical Outcomes Study, and Kwon's Questionnaire for Maladjusted Problems of Demented. Results indicated that caregivers' burden with demented patient related to physical symptoms and depression positively, and perceived health and subjective well-being negatively. Social supports showed moderate effects on influences of caregiving burden in perceived health, depression, and subjective well-being of family caregivers with demented patients. It was identified the possibility of their buffering effect on negative results of caregiving burden with demented patients. Since caregiving burden accounted for the 34% of the variances for family caregivers' physical symptoms and depression, researchers discussed the promotion and intervention of their health and quality of life. Beside of different effects of social supports with level of caregiving burden, with previous studies it was discussed some saliant findings such as family caregivers with patients who showed severe dementia symptoms were perceiving even less supports from others.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.87-92
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• 2014

Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

• Journal of Oriental Neuropsychiatry
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• v.9 no.2
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• pp.45-51
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• 1998

Purpose : This study has an experiment on finding how Hyangbujapamultang advanced the learning and memory of rat to find the method to improve the failure of memory which is the symptom of dementia.Method : In the experiment, rats were divided the control group (14 rat) which medicate the excipient into the sample group (17 rat) which medicates Hyangbujapalmutang. And the learning ability test and the memorv test was practiced to using the task of radial arm maze.The learning ability test had the presupposition that, when a rat which frequents 8 tracks makes am error not exceeding one time for 3 days without a break, it passes the test.First experiment compared total days when the control group passed the test with total days when the sample group it.The memory test practiced after 24 hours when the learning ability test was over. When a rat frequents 4 tracks, the gates is cut off during 30 seconds. Here the number of error at the control group with that of the sample group.Result: In the learning ability test, the sample group needed 5.82${\pm}$0.37 days to pass the test and the control group needed 6.43${\pm}$0.67 days. In the memory test, the sample group errored 0.29${\pm}$0.37 times and the control group errored 1.86${\pm}$0.78 times.Conclusion : In the learning ability test, the sample group passed the test earlier than the control group, but any statistical correlationship couldn't be found in it. In the memory test, the sample group had the pregnant reduction of the number of error in comparison with the control group.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.1
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• pp.256-261
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• 2008

Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.

• Journal of the Korea Convergence Society
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• v.13 no.4
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• pp.71-78
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• 2022

Parkinson's disease (PD) is clinically characterized by a variety of motor and non-motor symptoms, including cognitive and neuropsychiatric symptoms. Integrating a large variety of symptoms into a small number of clinical subtypes could be valuable for appropriate and early therapeutic intervention. As a first step toward this aim, this study attempted to identify correlation patterns among motor, cognitive and neuropsychiatric symptoms in PD without dementia. One hundred four non-demented patients with PD underwent a comprehensive motor, neuropsychological, and neuropsychiatric assessments. Factor analysis was performed to identify correlation patterns among demographic, motor, cognitive and neuropsychiatric variables. The eight factors were extracted: 1 motor-related, 3 cognitive-related and 4 neuropsychiatric factors. We indentified that characteristics of correlation can have associated symptom pattern in the disease process of Parkinson's disease. The current results suggest that a broad range of motor and non-motor symptoms in PD may be reducible to a small number of clinical parameters, which may be useful for identifying clinical subtypes of PD for individual patients.

• Journal of Agricultural Extension & Community Development
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• v.30 no.1
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• pp.1-13
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• 2023

This study aims to examine the effect of healing program using insect. For the insect resources, the program uses 3 species of emotional insects. The subjects were a total of 29, the elderly with mild dementia and adults with developmental disabilities in the facility. The activities are 9 programs in total and each program takes 2 hours once a week. For data collection, we measured a blood pressure, stress level using autonomic nervous system activity, and scale of happiness, depression and insomnia by a survey. The datas were collected every week before and after the program. As a result of paired-sample t-test analysis, the participants of the agro-healing program using insects had positive effects as follows: reducing a depression, relieving a symptom of insomnia and stabilizing a blood pressure. Through the results of this study, it was possible to confirm the positive effects of the agro-healing program using insects. If farms lead agro-healing program using insects on their own, it could be expected to contribute to improve the quality of life through agriculture as well as to improve the farms' income.