• Title/Summary/Keyword: Medical illness

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Mediation Effect of Self-Efficacy on the Relationship between Perceived Self-Management Support and Health-Related Quality of Life among Cancer Survivors (암 생존자의 지각된 자기관리 지지와 건강관련 삶의 질의 관계에서 자기효능감의 매개효과)

  • Lee, Bo Gyeong;Lee, Tae Sook;Kim, Soo Hyun
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.298-306
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    • 2019
  • Purpose: This study aimed to examine the levels of perceived self-management support, self-efficacy for self-management, and health-related quality of life (HRQoL) in cancer survivors, and to identify the mediating effect of self-efficacy in the relationship between perceived self-management support and HRQoL. Methods: This study used a descriptive correlational design. Two hundred and four cancer survivors who had completed treatment participated in the study. Measurements included the Patient Assessment of Chronic Illness Care Scale, the Korean version of the Cancer Survivors' Self-Efficacy Scale, and the Medical Outcomes Study Short Form-36. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and multiple regression analysis using Baron and Kenny's method for mediation. Results: The mean score for perceived self-management support was 3.35 out of 5 points, self-efficacy was 7.26 out of 10 points, and HRQoL was 65.90 out of 100 points. Perceived self-management support was significantly positively correlated with self-efficacy (r=.29, p<.001) and HRQoL (r=.27, p<.001). Self-efficacy was also significantly correlated with HRQoL (r=.59, p<.001). Furthermore, self-efficacy (${\beta}=.55$, p<.001) had a complete mediating effect on the relationship between perceived self-management support and HRQoL (Z=3.88, p<.001). Conclusion: The impact of perceived self-management support on HRQoL in cancer survivors was mediated by self-efficacy for self-management. This suggests that strategies for enhancing self-efficacy in cancer survivors should be considered when developing self-management interventions for improving their HRQoL.

Communication Experiences and Needs among the Critically Ill with an Artificial Airway: An Integrative Review (인공기도를 가진 중환자실 환자의 의사소통 경험과 요구에 관한 통합적 문헌고찰)

  • Kim, Soo Hyun;Kim, Juyoung;Choi, JiYeon
    • Journal of Korean Critical Care Nursing
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    • v.14 no.2
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    • pp.24-41
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    • 2021
  • Purpose : The aim of this integrative review was to describe communication experiences and needs among the critically ill with an artificial airway and evaluate relevant intervention studies. Methods : Using the method employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental ones) were identified and evaluated. Results : Communication experiences while having an artificial airway, identified either by patients' recall or direct observation, were predominantly negative. However, positive experiences were reported in patients with improvements in physical conditions and functions. Patients' communication needs were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested included alternative and augmentative communication strategies, communication intervention packages, and voice restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using various methods including self-report surveys, interviews, and observations. Conclusions : The findings from this review represent the state of science regarding communication of the critically ill whose vocal abilities are inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures are warranted to better understand and support the complex needs of this highly vulnerable patient population.

Mental Health in Adolescents with Allergic Diseases-Using Data from the 2020 Korean Youth's Risk Behavior Web-based Study (알레르기 질환 청소년의 정신건강: 2020 청소년 건강 행태 온라인 조사 활용)

  • Park, Cho Hee
    • Journal of Industrial Convergence
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    • v.20 no.1
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    • pp.87-96
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    • 2022
  • This study aims to understand the actual conditions of adolescents with allergic diseases and factors related to mental health. It is intended to provide basic data for disease management. As for the research method, big data of the 16th Youth Health Behavior Survey were analyzed secondary, and x2-test was used using the SPSS 25 program8, odds ratio and 95% confidence interval were calculated to determine the degree of association, and multi-logistic regression analysis was performed. Studies have shown that 37.1% of adolescents with allergic diseases have stress perception, 27.6% of depression experience rate and 12.5% of suicidal thoughts, and the likelihood of stress perception, depression experience, and suicidal thoughts among adolescents with allergic diseases was higher. As a result of this study, it was found that the presence or absence of allergic diseases in adolescents has a significant effect on mental health, and we intend to use it as basic data for prevention and research on diseases that can lead to mental illness and adolescent mental health.

The Development of a Tool for Assessment of Spiritual Distress in Cancer Patients (암 환자의 영적 디스트레스 측정도구 개발)

  • Kim, Jin Sook;Ko, Il-Sun;Koh, Su Jin
    • Journal of Korean Academy of Nursing
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    • v.52 no.1
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    • pp.52-65
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    • 2022
  • Purpose: This study was conducted to develop a scale to measure spiritual distress in cancer patients. Methods: A total of 69 preliminary items for the spiritaul distress assessment tool (SDAT) were compiled, based on a literature review, selection of empirically relevant items through concept analysis of hybrid models, confirmation of content validity by experts, cognitive interviews, and a pretest. Self-administered questionnaires were collected between April 1 and July 31, 2018, from 225 cancer patients at four medical institutions and one nursing home. The data were analyzed using item analysis, exploratory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity. Reliability was tested by Cronbash's α coefficient. Results: The final version of the SDAT consisted of 20 items. Five-factors, loss of peace, burden of family, avoidance of confronting death, guilt and remorse, regret for not being able to apololgize and forgive were extracted, and showed 62.8% of total variance. The factors were confirmed through convergent and discriminant validity. Criterion validity was confirmed by functional assessment chronic illness therapy spiritual well-being scale 12 (FACIT-Sp12). The overall Cronbach's α was .91, and the coefficients of each subscale ranged from .78~.83. Conclusion: The SDAT for cancer patients is valid and reliable. It is suggested that the tool can be used to measure spiritual distress in cancer patients.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

The severity of clinical symptoms according to cancer diagnosis in fever patients visiting the emergency department: a retrospective analysis (응급실에 내원한 발열 환자에서 암 진단 유무에 따른 임상증상의 중증도에 대한 후향적 조사 연구)

  • Eun Seam Lee;Purum Kang;You Kyoung Shin;Geun Hee Seol
    • Journal of Korean Biological Nursing Science
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    • v.25 no.2
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    • pp.105-112
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    • 2023
  • Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

Proposal on the Diagnostic Criteria of Definite Isolated Otolith Dysfunction

  • Park, Han Gyeol;Lee, Jun Ho;Oh, Seung Ha;Park, Moo Kyun;Suh, Myung-Whan
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.103-111
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    • 2019
  • Background and Objectives: Dizzy patients with abnormal otolith function tests, despite a normal caloric response, are defined as having specific (isolated) otolith organ dysfunction. This study was performed to compare the differences in clinical presentation between isolated otolith dysfunction (iOD) patients with lab- and Sx-based iOD group and lab-based iOD symptoms. Subjects and Methods: The medical records of 23 iOD patients with normal caloric response but abnormal cervical vestibular evoked myogenic potential (VEMP), ocular VEMP, or subjective visual vertical were reviewed. Non-spinning vertigo was considered as otolith-related symptoms. The patients' age, onset of dizziness, Numeric Rating Scale on the severity of dizziness, and concomitant vestibular disorders were analyzed. Results: Patients in the lab-based iOD group were significantly older than those in the lab- and Sx-based iOD group. Known vestibular disorders were significantly more common in the lab-based iOD group (83.3%) compared to the lab- and Sx-based iOD group (18.2%). Despite the normal caloric response, catch-up saccade was found in the video head impulse test in more than half (54.5%) of the lab-based iOD group patients. There was no catch-up saccade in the lab- and Sx-based iOD group. There were no significant differences in gender ratio, frequency of dizziness attacks, and duration of illness. Conclusions: We propose new definitions of definite iOD (lab- and Sx-based iOD) and probable iOD (lab- or Sx-based iOD). These new definitions may help researchers to identify patients who are more likely to have true iOD, and facilitate comparisons of results between different studies.

Public Attention to Crime of Schizophrenia and Its Correlation with Use of Mental Health Services in Patients with Schizophrenia (조현병 환자의 범죄에 대한 대중의 관심과 조현병 환자의 정신의료서비스 이용과의 상관관계)

  • Park, Hyunwoo;Lee, Yu-Sang;Lee, Sang Yup;Lee, Seungyeoun;Hong, Kyung Sue;Koike, Shinsuke;Kwon, Jun Soo
    • Korean Journal of Schizophrenia Research
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    • v.22 no.2
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    • pp.34-41
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    • 2019
  • Objectives: This study was performed to examine the effects of the public attention to 'crime of schizophrenia' on the use of mental health services in patients with schizophrenia using big data analysis. Methods: Data on the frequency of internet searches for 'crime of schizophrenia' and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. Results: The number of outpatients correlated negatively with public attention to 'crime of schizophrenia' in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. Conclusion: These findings suggested that public attention to 'crime of schizophrenia' could negatively affect illness behavior in patients with schizophrenia.

A Survey Study on Discharge Process of Critically Ill Patients: for Residents at a Tertiary Hospital in Korea (중증 환자 퇴원에 대한 설문연구: 한국의 일개 상급종합병원 전공의를 대상으로)

  • Hye Jin Jeong;Sun Young Lee;Belong Cho;Jeongmi Shin;Min Sun Kim
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.15-32
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    • 2024
  • Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.