• Title/Summary/Keyword: Insomnia symptoms

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The Experience of Parents Whose Child is Dying with Cancer (암 환아 부모의 경험에 대한 질적 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.491-505
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    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

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Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study (조현병 환자에서 장기지속형 항정신병 주사제 팔리페리돈 팔미테이트의 효능과 안전 : 24주 개방형 연구)

  • Kang, Hyun-Ku;Hahm, Woong;Shon, In-Ki;Paik, In-Ho
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.111-117
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    • 2013
  • Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

The Study About the Clinical Use of Gwanjung-tang (관중탕의 임상적 활용에 대한 연구)

  • Im, Dong-Hwan;Kim, Dal-Rae
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.2
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    • pp.30-42
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    • 2008
  • 1. Objectives This paper was tried to find out the clinical use of Gwanjung-tang by comparing patients' chief complain and natural symptom. 2. Methods The study was researched as clinically with medical records of 88 patients who visited a certain oriental medicine clinic which is in Seoul during January, 2000 and June, 2006. 3. Results 1) The male patient who was treated with Gwanjung-tang(寬中湯) is rare. The rate of patients who visited clinic in her forties is 27.3%, in fifties is 18.2%, in thirties is 15.9%, in sixties is 12.5%, in twenties is 10.3%. 2) Chief complain which made patients to visit clinic is a chest pain(19.3%), back pain and shoulder pain (15.9%), edema (12.5%), headache (9.1%), irregular menstruation (8.0%), dyspepsia (8.0%), fatigue (8.0%), insomnia (5.6%), menopausal disorder (4.5%), lumbago (4.5%), abnormal condition of stools (2.3%), and abnormal condition of urine (2.3%). 3) Natural symptom is classified into appetite, digestion, stools, urine, sweat, and sleep. The rate of patients who complained abnormal condition of digestion is 71.6%, of sleep is 59%, of stools is 52.3%, of urine is 47.7%, if sweat is 34.1%, and of appetite is 30.7%. 4) The rate of patients who is treated with Gwanjung-tang between thirty and forty packs is 43.2%, twenty packs is 39.7%, between fifty and sixty packs is 5.7%, between seventy and eighty packs is 2.3%, and between ninety and hundred packs is 3.4%. 5) The rate of patients who is treated with Gwanjung-tang during 15 days is 45.5%, between 16 and 30 days is 26.2%, between 31 and 60 days 7.9%, between 61 and 90 days 3.4%, between 91 and 120 days is 4.5%, and more than 120 days is 12.5%. 6) There are not many cases that chief complain was abnormal condition of digestion (8.0%), sleep (5.6%) stools (2.3%), and urine (2.3%). But the rate of patients who complained discomfort of digestion(71.6%), sleep(59%) stools (52.3%), and urine (47.7%) is significantly high. 7) According to "Sasang Sin Pyeon", Gwanjung-tang was used in To-sa-gwak-ran (吐瀉藿亂), Hae-su (咳嗽), Jeok-chui (積聚), Pyo-han -bu-jong (表寒浮腫), Chang-man (脹滿), Chil-gi (七氣), Dam-um (痰飮), Dam-goe (痰塊), Seom-jwa-yo-tong (閃挫腰痛), Bi-tong (臂痛) of Soeumin, and it is corresponds with clinical cases for various components. 4. Conclusions Gwanjung-tang is a medicine of reconciliation, and it makes Stomach to be warm and take down Yin Qi. The most important effect of Gwanjung-tang is Sun-qi(順氣). So it is considerable that Gyejibanhasenggang-tang (少陰人 桂枝半夏生薑湯), Hyangsayangwi-tang (少陰人 香砂養胃湯), and Gwakhyangjunggi-san (少陰人 藿香正氣散) is also effective to symptoms above, because these are medicines of reconciliatio.

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The Predictive Factors of the Serum Creatine Kinase Level Normalization Time in Patients with Rhabdomyolysis due to Doxylamine Ingestion (독시라민 중독으로 발생한 횡문근융해증 환자에게서 혈중 크레아틴인산활성화효소 수치가 정상화되는 시기를 예측할 수 있는 인자)

  • Shin, Min-Chul;Kwon, Oh-Young;Lee, Jong-Suk;Choi, Han-Sung;Hong, Hoon-Pyo;Ko, Young-Gwan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.156-163
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    • 2009
  • Purpose: Doxylamine succinate (DS) is frequently used to treat insomnia and it may induce rhabdomyolysis in the overdose cases. The purpose of this study is to evaluate the factors that can predict the serum creatine kinase (CK) level normalization time for patients with rhabdomyolysis due to DS ingestion. Methods: This study was conducted on 71 patients who were admitted with rhabdomyolysis after DS ingestion during the period from January 2000 to July 2009. Rhabdomyolysis was defined as a serum CK level over 1,000 U/L. The collected data included the general characteristics, the anticholinergic symptoms, the ingested dose, the peak serum CK level, the time interval (TI) from the event to the peak CK level and the TI from the event to a CK level below 1,000 U/L. We evaluated the correlation between the patients' variables and the TI from the event to the peak CK level time and the time for a CK level below 1,000 U/L. Results: The mean ingested dose per body weight (BW) was $30.86{\pm}18.63\;mg/kg$ and the mean TI from the event to treatment was $4.04{\pm}3.67$ hours. The TI from the event to the peak CK level was longer for the patients with a larger ingestion dose per BW (r=0.587, p<0.05). The CK normalization time was longer for the patients with a larger ingested dose per BW (r=0.446, p<0.05) and a higher peak CK level (r=0.634, p<0.05). Conclusion: The ingested dose per BW was correlated with the TI from the event to the peak CK level, and the ingested dose per BW and the peak CK level have significant correlations with the CK normalization time. These factors may be used to determine the discharge period of patients who had rhabdomyolysis following a OS overdose.

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The Qualitative Study on the Triggering Factors of Private Security Guards' Stress (민간경호원의 스트레스 유발요인에 관한 질적연구)

  • Kim, Jin-Hwan
    • Korean Security Journal
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    • no.15
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    • pp.89-105
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    • 2008
  • The aim of this study is to examine the primary causes of security guard's stress by conducting a survey of 50 guards engaging in security companies in Seoul and Gyeonggido. The following results are attained by an inductive content analysis of conviction interview data through in-depth interview of qualitative study method. 1. Factors of stress related to personal problems. The stress by personal problems is resulted from two factors. One is the physical strength inferiority, which leads to negative thoughts, dismay, mental conflict and tension. The other is complex about not-specializing security, which causes discord with his/her supervisor or co-workers and a feeling of uneasiness. 2. Factors of stress related to human relationship. The stress due to human relations is constantly resulted from discord with his/her supervisor and inclined to be accumulated. The mental conflict is elated in feeling that the manager's instructions are not right. So this factor makes them want change of occupation. Also working conditions are different from those of their friends, which causes them not to spend a lot of time with their friends. 3. Factors of stress related to domestic life It appears that most security guards are under stress due to their spouses' discontent with a small number of wages. Also it is reported that male guards are under stress in case of unhappy conjugal relations. And security guard's life is restricted much more than that of workers in a general occupation because of standing ready for mobilization and 24-hour service. So some of male guards experienced an early symptoms of a morbid suspicion about their wife's chastity and are suffering from insomnia as an occupational disease.

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Has Snoring Significance for Predicting Obstructive Sleep Apnea Severity? (코골이가 수면무호흡증의 중증도를 예측할 수 있을까?)

  • Kim, Si Eun;Park, Bong Soo;Park, Si Hyung;Shin, Kyong Jin;Ha, Sam Yeol;Park, Jin Se;Park, Kang Min
    • Annals of Clinical Neurophysiology
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    • v.17 no.2
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    • pp.61-67
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    • 2015
  • Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

Sleep Paralysis in Schizophrenia and Mood Disorder (정신분열병과 기분장애에서의 수면마비)

  • Park, Jae-Hong;Yang, Chang-Kook
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.115-121
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    • 2002
  • Objectives: Although sleep paralysis (SP) has been known as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in the general population. However, the prevalence of SP and its associated factors in patients with major psychiatric disorders remain unknown. This study investigated the prevalence of SP and a variety of associated experiences in those patients. Methods: The subjects were 160 psychiatric patients and 143 age- and sex-matched controls. The Korean version SP questionnaire as well as the Sleep-Wake Schedule, Epworth Sleepiness Scale and Insomnia Severity Index were administered to all the subjects. The patients were referred from Dong-A University Hospital and consisted of 74 diagnosed as schizophrenia (47.7%), 26 as bipolar disorder (16.8%) and 55 as major depression (35.5%). Results: Nearly 42% of the patient group and 39% of the control group had experienced at least one episode of SP in their lifetime, with no significant difference between the groups. However, the patient group had experienced SP more frequently than the control group. Among all subjects, no gender difference in SP incidence was found. The peak age of onset was in the range of 16-25 years for both groups. Over eight tenths of both groups reported hallucinations and over seven tenths of both groups experienced fear accompanying SP. Conclusion: This study shows that there is no difference in the lifetime prevalence of SP between psychiatric patients and the general population, whereas frequency of SP experience is higher in psychiatric patients. Terrifying hallucinations and fearful feelings frequently accompany SP in both groups.

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Functional Dyspepsia (기능성 소화불량증)

  • Song, Kyung Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.3-8
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    • 2016
  • Functional dyspepsia is one of the most common bowel disorders as prevalent of 7.7% Korean population. The cardinal manifestations include bothersome postprandial fullness, early satiation, epigastric burning or pain. These features are chronic and should be presented recurrently with no other compatible organic disease to explain the symptoms. Even though it is not life-shortening, functional dyspepsia usually make the health-related quality of life worse especially if other functional bowel disorder coexist. The coexistence of functional bowel disorders is called as 'overlap syndrome'. Anxiety, somatization and insomnia is more prevalent in overlap syndrome compared with sole functional bowel disorder. Therefore, it is worthwhile that physician interviews and elucidates whether the dyspeptic patient had other kinds of functional bowel disorders, and manages the underlying psychotic pathology. Placebo effect is large in functional dyspepsia, and there is only four kinds of prokinetics that is proven to be superior to placebo. Adverse events relating prolonged administration of prokinetics sometimes fatal or irreversible, physician willing to describe prokinetics should be familiar to the possible adverse effects and the relating risk factors. Pathologic acid reflux is not uncommon in functional dyspepsia, and acid-suppressant is equivalent to the prokientics in most of dyspeptic patients.

Effects of Korean Medicine Treatment in Post-acute COVID-19 Syndrome: A Retrospective Case Series of 15 Patients (한방병원에 내원한 급성기 이후 코로나-19 환자 15명에 대한 임상적 특징 및 치료 분석 : 사례군 연구)

  • Park, Jiwon;Hong, Sung-eun;Shin, Jeong-Won;Kim, Kwan-Il;Lee, Beom-Joon;Jung, Hee-Jae
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.396-412
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    • 2022
  • Objective: The aim of this study was to identify the clinical features of post-acute COVID-19 syndrome and the efficacy and safety of Korean medicine treatment. Methods: This study was conducted on 15 patients with post-acute COVID-19 syndrome who visited the outpatient Allergy, Immune, and Respiratory System Department at Kyung Hee University Korean Medicine Hospital from January 10, 2021 to April 10, 2022. We retrospectively analyzed the charts of 15 patients and collected clinical characteristics, Korean medicine treatments, outcome variables (Numeral Rating Scale (NRS), modified Medical Research Council scale (mMRC), Leicester Cough Questionnaire (LCQ), Quality of Life Visual Analog Scale (QOL-VAS), The Post-COVID-19 Functional Status (PCFS)), adverse events, etc. Results: Of the 15 patients, seven (46.7%) were men, and the average age of all patients was 49.7±13 years. The most common symptom was cough (n=9, 60%), and it was followed by dyspnea or increased respiratory effort, fatigue, insomnia, anosmia, etc. The herbal medicine was prescribed for all 15 patients, and Saengmaek-san (n=8, 53.5%) was the most prescribed. Additionally, acupuncture and cupping were performed in four patients (26.7%) each, and electroacupuncture was applied to one patient (6.7%). As a result of Korean medicine treatment, NRS, mMRC, LCQ, QOL-VAS, and PCFS showed improvement, and adverse events were mild. Conclusions: This study presented the clinical features of post-acute COVID-19 syndrome and suggested that Korean medicine treatment may be effective in alleviating related symptoms and enhancing quality of life.

Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.