Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.
The Journal of Korean Society for School & Community Health Education
/
v.13
no.2
/
pp.29-44
/
2012
The purpose of this study is to provide substantial foundation to establish effective sex education plan for female college students. For this purpose, we compared female college students with health related majors and the ones with non-health related majors in knowledge in sex, attitude toward sex, and sexual experience. We took the form of self-recording to survey 269 single female college students. The result is as follows. For knowledge in sex, including reproductive organs, contraception, delivery, sexual disease, and sexual intercourse, students with health-related majors(20.59) gained higher scores than students with non-health related majors(16.82). Scores for attitude toward sex indicated 2.43 for the health related majors and 2.35 for the non-health related majors. Attitude toward pre-marital sex, sex admissibility, and abortion showed especially distinct result between the two groups. Whether a student has ever engaged in sexual intercourse served as a significant variable to determine knowledge in sex overall, and the indexes such as sexual pleasure, chasteness, marital values, and attitude towards sex indicated significant differences. The result may be interpreted that the students with sexual experience tend to show more open attitude toward sex. The result indicated that contraception, pregnancy, and delivery were the parts that the participants most wanted to be educated on. Knowledge in sex is both positively correlated with attitude toward sex and sexual behavior. Also, the result indicates that knowledge in sex, both subjective and objective, significantly affects sexual behavior.
The purposes of this study were to investigate the physical discomforts and sexual life pattern and to identify the relation between the physical discomforts and the satisfaction of sexual life in women with hysterectomy. The subject were 301 women who lived with their spouses from 3 months to 2 years after hysterectomy in S. University Hospital. The data were collected using a self-reported questionnaire by mail, which composed of 25 items of physical discomforts, restarting time and frequency of sexual intercourse, and 10 items of sexual satisfaction, The results were as follows: 1) The mean score of physical discomforts was 13.22 and range of score was 0-45. 1.7% of 301 women had no physical discomforts and 12.0% of them complained of severe physical discomforts such as fatigue, lumbago and pain of extremities. 2) The women with hysterectomy complained of fatigue(76.1%), lumbago(68.8%), pain of extremities(63.5%), weight gain(55.5%), vaginal dryness(50.8%) and symptom of estrogen deficiency such as perspiration (47.5%), flush(41.2%) and palpitation (38.5%). As unusual symptom, numbness of thigh (20.3%) and acne(16.3%) were identified. 3) There was no significant difference between the degree of physical discomforts and the laps of time after hysterectomy. But the score of physical discomforts was lower in women with vaginal hysterectomy than in women with abdominal hysterectomy. 4) The mean score of sexual satisfaction was 33.11 and range of score was 10-50. There was no significant difference between the degree of sexual satisfaction and the lapse of time after hysterectomy. 83.8% of women had not change of sexual life satisfaction after hysterectomy. The women restarted sexual intercourse in average 2.57 months after hysterectomy. 5) There was a negative correlation between the physical discomforts and the sexual satisfaction. In conclusion, nurses should make the discharge educational program of the physical discomforts and the sexual pattern for women with hysterectomy in hospital.
Background : Hepatocellular carcinomoma is the 3rd most common malignancy and the 2nd most common cause of death in Korea. The prediction of life-expectancy in terminal cancer patients is a major problem for patients, families, and physicians. We would like to investigate the prognostic factors of hepatocellular carcinoma, and therefore contribute to the prediction of the survival time of patients with hepatocellular carcinoma. Methods : A total of 91 patients(male 73, female 18) with hepatocellular carcinoma who were admitted to the hospital between January and lune 1995 were entered into the study, and data were collected prospectively on 28 clinical parameters through medical obligation record. We surveyed an obligation and local district office records, and confirmed the surivival of patients till July, 1996. Using Cox-proportional hazard model, give the significant variables related to survival. These determined prognostic factors. Life regressional analysis was used, there were calculated predicted survival day based on combinations of the significant prognostic factors. Results : 1) Out of 91 patients, 73 were male, and 18 were female. The mean age was $56.7{\pm}10.6$ ears. During the study, except for 16 patients who could not follow up, out of 75 patients, the number of deaths was 57(76%) and the number of survivals was 18(24%). 2) Out of the 28 clinical parameters, the prognostic factors related to reduced survival rate were prothrombin time<40%(relative risk:10.8), weight loss(RR:4.4), past history of hypertension (RR:3.2), ascites(RR:2.8), hypocalcemia(RR:2.5)(P<0.001). 3) Out of five factors, the survival day is 1.7 in all of five, $4.2{\sim}10.0$ in four, $10.4{\sim}41.9$ in three, $29.5{\sim}118.1$ in two, $124.0{\sim}296.6$ in one, 724.0 in none. Conclusion : In hepatocellular carcinoma we found that the prognostic factors related to reduce survival rate were prolonged prothrombin time(<40%), weight loss, past history of hypertension, ascites, and hypocalcemia(<8.7mg/dl). The five prognostic factors enabled the prediction of life-expectancy in patients with hepatocellular carcinoma and may assist in managing patients with hepatocellular carcinomal.
Purpose: We aimed to investigate the efficacy and side effects of $Ultracet^{(R)}$ in relieving cancer pain in setting. Methods: Sixty-one cancer patients over 18 years old, who had cancer pain with or without medication, were enrolled. Pain and other variables were evaluated before and after treatment with $Ultracet^{(R)}$ for 2 weeks, using Korean version of Brief Pain Inventory. Results: Of 61 patients with assessable efficacy data, the maximum pain intensity(PI) experienced in a day were $5.18{\pm}1.41\;and\;4.82{\pm}1.94$, before and after treatment with$Ultracet^{(R)}$ respectively (P=0.113). The minimum PI experienced in a day were $1.2{\pm}1.05\;and\;0.87{\pm}1.35$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.038). The average PI experienced in a day were $3.61{\pm}1.01\;and\;3.15{\pm}1.73$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.022). The current PI were $3.63{\pm}1.25\;and\;2.85{\pm}1.94$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.003). Regarding the quality of life, only mood changed for the better in 49 patients who were treated with $Ultracet^{(R)}$ alone ($1.98{\pm}1.73\;and\;1.35{\pm}1.15$, before and after treatment respectively; P=0.046). There were five (8.2%) adverse events associated with $Ultracet^{(R)}$ treatment. Conclusion: $Ultracet^{(R)}$ seems effective and safe in ambulatory patients with cancer pain.
Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.
Purpose: A central venous catheterization (CVC) is frequently used for delivering anti-cancer chemotherapeutic agents, blood products, parenteral nutrition, and other intravenous therapy in patients with cancer. Major complications of CVC use are thrombosis, infection, and mechanical complications. The aim of this study was to evaluate the frequency of CVC complications and related factors. Methods: The records of cancer patients who received a CVC at our university hospital from March 2001 to October 2006 were retrospectively investigated. Chi square test was used to determine whether there was a related factor for thrombosis or infection, and Kaplan-Meier analysis for univariate analysis, or Cox-regression analysis for multivariate analysis was used for catheter life span. Results: Three hundred and ten CVCs (235 nontunneled, 75 tunneled) were inserted in 310 patients (157 males, 153 females). Among them, 104 had hematologic cancers and 206 had solid cancers. The mean age of the patients was 52 years (range, 19~82 years). CVC complications occurred in 60 cases (19%). CVC-related thrombosis occurred frequently in patients with infection (P=0.003), whereas diagnosis, catheter type, transfusion, and TPN history did not affect infection or thrombosis. The mean duration of the catheter was 102 days (range, 2~1,330 days), and the duration was prolonged in patients with tunneled catheters (P=0.000), or without transfusion through CVC (P=0.030). Conclusion: The major complications for long-term use of a CVC were infectionand thrombosis. Tunneled catheter was effective tool for long term use, especially in cases without transfusion through CVC. The studies on the prevention or treatment ofthrombosis and infection are, therefore, warranted by using CVC for an extended period of time.
Purpose : This study was designed to evaluate the perception of cancer in the students of Korea University. Methods : 1,000 students of Korea University were surveyed by questionnaire from March 2001 to September 2002. Nine hundred ninety two complete questionnaires were returned. The data were analyzed by descriptive statistics, and Chi-square analysis using the SPSS program. Results : 701 students (76.1%) replied that cancer is a curable disease. However, the degree of satisfaction for cancer treatment with modem clinical medicine was low (37.5%). Moreover, they thought that there was no difference between the efficacy of treatment by chemotherapy, alternative medicine, or dietary modification. But, the positive evaluation for the effectiveness of chemotherapy in the students who had cancer patients in their families was higher than that in the students without the experience of cancer patients in their families. Six hundred ninety four students (75.3%) replied positively for euthanasia in terminal cancer patients. And they thought that the dignity and the right of the patients were the most important point that should be considered in making the decision of euthanasia. Conclusions : The credibility to modem clinical medicine for cancer treatment was relatively low in the students of Korea University who had no cancer patients in their families. So, further studies and trials will be warranted to evaluate the causes of these results and improve the credibility of modem clinical medicine for cancer treatment in the general population.
Purpose : Amont the various issues concerning bio-ethics, the concern on euthanasia has increased along with the development of medical technology. Thus, the general public tends to have more liberal opinion. They have detail research data and real practices in US, Europe and Australia, but we lack such studies in our country. This study was undertaken to address the need of studies on the recognition of euthanasia among the public because the existing studies have been focused on the medical staff. Methods : Survey 413 people the age of 17 or more, from May to July 2000. Testify the data on the variation of demography and the recognition of euthanasia by using SAS 6.12, the statistic program. Results : 304 people (73.6%) think that euthanasia should be legislated, 156 people (37.8%) permit euthanasia to the rage of voluntary one, and 234 people (56.6%) permit passive euthanasia. When the subject of voluntary euthanasia was himself, more people whose age is 35 or more (P=0.001) responded that they will undertake euthanasia. And, on issues related to the passive euthanasia, one's educational background (P=0.046) and economic power (P=0.040) arrangement showed significant differences. When the subject of voluntary euthanasia is other people, more people whose age is 35 or more than 35 (P=0.001), whose sex is male (P=0.001), and married people (P=0.002) were for allowing the matter. For the subject of passive euthanasia, survey participant's occupation (P=0.016) created meaningful difference. More people whose age is 35 or more than 35 responded that they want voluntary euthanasia for themselves (P=0.001), and in the case when euthanasia is legislated, marital status (P=0.002) also shows meaningful difference. Passive euthanasia is permitted by the more people whose age is less than 35 for respondents other people (P=0.001), marital status show meaningful difference in case for respondent himself. In the case of legal euthanasia is more people whose age is 35 or more than 35 (P=0.001), sex is male (P=0.004) and more married people (P=0.001) responded that they want voluntary euthanasia for other people. And, age (P=0.002), sex (P=0.001), education (P=0.025) and economic power (P=0.001) show meaningful difference for case the subject of passive euthanasia. Conclusion : Most of general public responded that the legislation on euthanasia is required; and, age, education and economic power seem to have an influence on their decisions on euthanasia. Not only such a study of demographic and sociological correlation; but, various basic data on the legislation of euthanasia are needed.
Purpose : To clarify the relation between psychosocial variables and cancer in Korea. Methods : Case-control study. Participants: 239 subjects in 2 university hospitals in Seoul completed a series of psychometric instruments(the Olson's FACES III and the Lee's 98-items life event scale). Results : In bivariable analysis, there were statistically significant difference in age and economic status(income): marginal significance in education status and marital status between the cases and controls. The family function type and stress score were not significantly different. The result of multivariable logistic regression, analysis showed that the risk of cancer was associated with economic status and marital status, but neither the family function nor the life event stress. Conclusion : In this study, we cannot prove the statistical association between the family function, life event stress and cancer. It is necessary to persevere in our efforts to clarify the relation between stress and disease and to develop the useful tools to measure the Korean family function and life event stress.
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