• Journal of Korean Academy of Nursing
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• v.39 no.5
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• pp.683-692
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• 2009

Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

• Korean Journal of Biological Psychiatry
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• v.24 no.4
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• pp.204-211
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• 2017

Objectives In this study, we identified the symptoms of insomnia, anxiety, and depressed mood in newly diagnosed women breast and thyroid cancer patients. Methods The subjects of this study were 1794 women patients who visited the Ewha Womans University Cancer Center for Women. They included 1119 newly diagnosed primary breast cancer patients and 675 newly diagnosed primary thyroid cancer patients. The patients completed the National Cancer Center Psychological Symptom Inventory (NCC-PSI) during their first follow-up visit after surgery, before starting chemotherapy or radiotherapy. The NCC-PSI is composed of the modified distress thermometer (MDT) and the modified impact thermometer (MIT) for insomnia, anxiety, and depressed mood. Results Anxiety severity was found to be greater in breast cancer patients than in thyroid cancer patients. Significant levels of anxiety, depressed mood and insomnia were present in 28, 24.5, and 20.7% in all the subjects, respectively. Moreover, anxiety symptoms, depressed mood and insomnia interfered with the daily lives of 20, 18.4, and 14.2% of all the subjects, respectively. Dealing with anxiety (18.8%) was found to need the most help, followed by dealing with insomnia (8.9%) and depressed mood (8.7%). Conclusions A significant level of distress was found in about 40% of the total subjects. Nearly 30% of newly diagnosed breast cancer patients reported significant anxiety symptoms and interferences with daily living caused by anxiety, which most commonly needed special care. Early assessment and management of psychological distress, especially anxiety, in breast and thyroid cancer treatment are very important to establish integrated cancer care.

• Korean Journal of Biological Psychiatry
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• v.17 no.3
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• pp.153-160
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• 2010

Objectives : Recurrence of mood episodes associated with a specific season has been described in various mood disorders. Seasonal change in mood and behavior as a lifetime trait is also observed in healthy individuals. This study aimed at comparing the lifetime trait of seasonal variations of mood and behavior between bipolar disorder patients and controls as well as investigating associated factors of seasonality. Methods : Subjects were ninety-four clinically stable patients with bipolar disorder and 188 age- and sex-matched healthy controls. Seasonality of mood and behavior was assessed retrospectively on lifetime basis using Seasonal Pattern Assessment Questionnaire(SPAQ). Results : The patient group showed a higher median global seasonality score(GSS) of SPAQ and a higher rate of seasonal affective disorder(SAD) compared to the control group(p < 0.0001). For subjects showing prominent seasonality, the seasonal symptom profile and seasonal pattern was similar in both patient and control groups. In addition to the diagnosis, female gender was shown to be a predictor of seasonality in the multiple linear regression analysis(p = 0.045). Conclusion : This study suggests that lifetime trait of seasonality may be related to the susceptibility of bipolar disorder.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.281-286
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• 1995

Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.201-212
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• 1997

Objectives: We attempted to study sleep habits and insomnia-associated factors in Korean rural adult population. Methods : In 1,441 adult subjects of three rural communities selected by cluster sampling, we administered an epidemiologic survey using questionnaire methods from July 14, 1996 to July 28, 1996. Results : 1) Mean sleep latency and mean time to sleep again after awakening during nocturnal sleep were longer in females than in males. Females suffered more frequently from insomnia symptom, awakening during nocturnal sleep. morning headache, dysphoric mood in the morning, and the feeling of 'not refreshed' on waking-up than males. 2) The older age group (defined as those older than 65 years) was found to have earlier bed-time, longer sleep latency, more frequent nocturia, longer time to sleep again after awakening during nocturnal sleep, and more frequent insomnia symptom. 3) The presence of insomnia symptom more than once a week was significantly associated with suffering from physical illness, being divorced-separated-widowed, frequently feeling depressed, nocturia, or low education level. 4) In multiple logistic regression analysis, old age, being female, low education level, frequently feeling depressed, and nocturia were independently associated with the presence of insomnia symptom more than once a week. Conclusion : We conclude that, in a Korean rural adult population, insomnia symptom increases with age and females usually suffer more from insomnia symptom than males. In addition, low education level, feeling depressed mood frequently, and nocturia are found to be significantly associated independently with the presence of insomnia symptom more than once a week.

• Anxiety and mood
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• v.18 no.2
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• pp.72-79
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• 2022

Objective : Any traumatic event can be a risk factor, for subsequent mental disorder. However, childhood trauma, especially in interpersonal nature, is associated with later development of complex symptom patterns. This study examined the role of dissociation as a mediator between childhood trauma and symptom complexity. Methods : A pooled data of 369 psychiatric outpatients at a university-affiliated hospital was analyzed for descriptive statistics, group differences, and bivariate correlation analysis to verify a structural model. The questionnaires included the Symptom Checklist-90-Revised, the Trauma History Screen, the Dissociative Experiences Scale-Taxon, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : When other trauma variables were controlled, childhood interpersonal trauma had significant correlation with symptom complexity (r=0.155, p=0.003). Among the paths analyzed, that of childhood interpersonal trauma and dissociation showed the greatest impact on symptom complexity (b=9.34, t=5.75, p<0.001). Based on the significance of the indirect impact, the results suggest a complete mediation impact of dissociation on symptom complexity. Conclusion : This study validated that childhood interpersonal trauma impacts symptom complexity, through the sequential mediating impact of dissociation. Thus, clinicians should understand childhood interpersonal trauma, dissociation, and symptom patterns in a complex and interacting mode, and develop effective pertinent treatment strategies.

• Anxiety and mood
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• v.8 no.2
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• pp.133-140
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• 2012

Objective : The aim of this study was to investigate how trauma and personality system was related by comparing TCI profiles of the trauma versus non-trauma groups and PTSD symptom positive (PTSD symptom [+] group) and PTSD symptom negative groups (PTSD symptom [-] group). Methods : We compared the difference of Temperament and Character Inventory (TCI) profiles between the trauma (n=61) and the non-trauma (n=61) groups, and between the PTSD symptom [+] group (n=40) and PTSD symptom [-] group (n=21). Results : Comparison of the TCI's seven higher dimensions between the PTSD symptom [+] and [-] groups showed significant differences only in C (Cooperativeness). And in the analysis of TCI's lower dimensions the significant differences were observed in the HA1 (Worry and pessimism), HA2 (Tension regarding uncertainty), and C4 (Compassion) subscales. However, significant differences in the higher dimensions appeared more clearly between the non-traumatized group and the traumatized group. Compared to the non-traumatized group, the traumatized group scored significantly higher in HA (Harm avoidance) and RD (Reward dependence), while lower in SD (Self-directedness). Conclusion : Overall, present results suggest that traumatic experiences may affect personality systems regardless of the development and of PTSD symptoms.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.4
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• pp.707-715
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• 2010

In this study, meridian massage is developed and applied on post menopausal Women with Hemodialysis to identify the effects of Menopausal Symptoms, Mood, Estradiol($E_2$), and Pain. The study was a nonequivalent control group pre-post test Quasi-experimental design. There were 17 people in the experimental group and 17 people in the control group. Meridian massage was performed for 4 weeks, 3 times a week for 20 minutes each sessions. The data were collected at pretest and posttest. SPSS win. 11.5 program was used. Fisher's exact test and Mann Whitney U-test were used to analyze the Pre-treatment homogeneity. Wilcoxon Sign Rank test was used to find out the effectiveness within each groups. Mann Whitney U-test was used in comparing between the two groups. After meridian massage, there were significant differences in menopausal symptoms in experimental group(z=-2.583, p=.010) and pain between groups(U=86.00, p=.040). $E_2$ was not effective in both groups. The mood was effective in both groups, since the mood had influenced by interviewer's collecting data. Meridian massage was effective in alleviating menopausal symptoms and pain of post menopausal women with Hemodialysis, but it is desirable to perform meridian massage to the patients for enough time.

• Anxiety and mood
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• v.8 no.2
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• pp.99-105
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• 2012

Objective : The aim of this study is to evaluate the five-factor model of personality in patients with obsessive-compulsive disorder (OCD) related to obsessive-compulsive symptom severity and the distinct symptom subgroups. Methods : We recruited 95 patients with OCD and 116 normal controls in the study. We used the short version of Revised NEO Personality Inventory and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the assessment. Results : Patients with OCD showed significantly higher scores in neuroticism than normal controls. On multiple linear regression analysis, we found that agreeableness and conscientiousness were associated with the total Y-BOCS scores. On subscale analysis, agreeableness and neuroticism were associated with the obsession subscale scores and only conscientiousness was associated with the compulsion subscale scores. Furthermore, we found that patients who have contamination/cleaning or symmetry/ordering/counting/arranging as a main symptom presentation had significantly higher mean scores in conscientiousness than patients who have harm due to injury/violence/aggression as a main symptom presentation. Conclusion : In this study, we found that specific personality factors are associated with the obsessive-compulsive symptom severity. In addition, this is the first study to investigate the relationship between the personality factors in the five-factor model and the distinct symptom subgroups in OCD.

• Asian Oncology Nursing
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• v.12 no.4
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• pp.297-304
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• 2012

Purpose: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. Methods: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine ($I^{131}$) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. Results: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. Conclusion: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.