• Title/Summary/Keyword: Nursing Health Assessment

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The Comparison of Fatigue of the Patients with Rheumatoid Arthritis, Lupus, and Fibromyalgia (류마티스 관절염.루프스.섬유조직염 환자의 피로 양상 비교)

  • Lee, Kyung-Sook;Song, Kyung-Ja;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.131-147
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    • 2000
  • Almost all patients with rheumatic disease experience fatigue. The fatigue affects the patient's life extensively at home and at work, therefore it is necessary to investigate the nature of the fatigue which the patients perceive. The purpose of this study is to explore the nature and pattern of fatigue of the patients with rheumatic diseases. Rheumatoid arthritis is typical disease for its joint involvement which leads to deformity. Whereas lupus is a characteristic systemic autoimmune disease and the fibromyalgia is characterized by the general bodyache and multiple local tenderness. The prevalence of these diseases and the fatigue was known to be higher in women than men. Therefore the subjects were woman patient diagnosed as rheumatoid arthritis, lupus or fibromyalgia, and they were recruited from the H-Rheumatic Disease Hospital. The two instruments, the Multidimensional Assessment of Fatigue by Belza(1995) and the Piper Fatigue Scale by Piper, et al(1995) were used to explore the nature and pattern of self-reported fatigue. In total, the data from 157 patients were analysed by the SPSS-PC program for statistical analysis. The results were as follows: 1. Most patients with rheumatic disease experienced fatigue and the degree of fatigue was at the middle range by the scores of the two instruments. 2. The degree of fatigue of the patients with fibromyalgia was the highest and the next was that of the patients with lupus and the fatigue of the patients with rheumatoid arthritis. But there were no statistically significant differences among the patients with three rheumatic diseases, except the subcategory, the meaning of fatigue of the Piper Fatigue Scale. 3. Even when the period of the symptom and pain were covariated, there were no statistically significant differences among patients with three rheumatic diseases. The fatigue of the patients with lupus and fibromyalgia is rarely investigated in Korea and this study can be the base for the further understanding of the patients with rheumatic diseases. Therefore repeated studies are required to identify the factors to affect the fatigue and to understanding the nature of the diseases and to develop the nursing interventions to alleviate the fatigue.

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Equating Two Health-related Quality of Life Instruments Applied to Cancer Survivors Who Underwent Palliative Care

  • Bongsam Choi;Heesu Kim;Sunhwi Bang;Byunggwan Kim;Jaekwang Shim
    • Physical Therapy Korea
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    • v.30 no.1
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    • pp.32-40
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    • 2023
  • Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL-BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

A Comparative Study on The Effect of Cupping and Moxibustion Therapy on Treating Constipation of Stroke Patients (부항-뜸 병행치료와 뜸 단독치료가 뇌졸중 환자의 변비 완화에 미치는 효과 비교)

  • Kim, Gyeong-Cheol;Kim, Yi-Soon;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.13 no.3
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    • pp.101-112
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    • 2009
  • Objectives : This comparative study aimed to identify the effect of the Buddeumi(cupping-and-moxibustion device) therapy and moxibustion-only therapy on treating constipation of stroke patients who were admitted in the hospital of oriental medicine. The research design was a nonequivalent control group pretest-posttest design. Methods : The subjects of the study consisted of 23 stroke patients, and they were divided into two groups : one was the experimental group of 11 patients and the other was the control group of 12 patients. The Buddeumi therapy and the moxibustion-only therapy were given respectively. Each Buddeumi and moxibustion-only therapies on the 天樞(ST25, right & left) in abdomen were administered to the each group for 40 minutes a total at 10 times. The posttest included the frequency of defecation with the Constipation Assessment Scale every day for one week after the experiment. The data were analyzed by the $x^2$ test, t-test, Fisher exact test, and repeated measures ANCOVA using SPSS/WIN 12.0 program. Results : The results were as follows : First, Hypothesis 1 : 'The patients who are given the Buddeumi therapy in the experimental group have a lower Constipation Assessment Scale than the control group.' was supported(F=4.367, P=0.049). Second, Hypothesis 2 : 'The patients who are given meridian acupressure in the experimental group have a higher frequency of defecation per week than the control group.' was supported(F=0.947, P=0.034). Accordingly, 'The patients who are given the Buddeumi therapy in experimental group have a higher effect on constipation than the control group.' was supported. Conclusion : The Buddeumi therapy reduced the constipation assessment scale of stroke patients and increased the frequency of their defacation per week. Therefore, the Buddeumi therapy could be an effective treatment for constipation of stroke patients.

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Effect of Breast-feeding Education and Follow-up care on the Breast-feeding Rate and the Breast-feeding Method - Focused on Home Visit and Phone Counselling - (모유수유교육과 추후간호방법이 산모의 모유수유실천율과 모유수유방법에 미치는 효과 - 가정방문과 전화상담을 중심으로 -)

  • Park, Sook-Hee;Koh, Hyo-Jung
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.30-43
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    • 2001
  • This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

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Effect of Sexual function and Sexual distress on Quality of life in Middle Aged Women with Osteoarthritis. (골관절염 중년여성의 성기능, 성스트레스가 삶의 질에 미치는 영향)

  • Kwon, Young Ae;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.11
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    • pp.209-218
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    • 2020
  • This study examined the sexual function, sexual distress, and quality of life of middle-aged women with osteoarthritis, as well as the factors influencing the quality of life. The participants were 121 middle-aged women who have been suffering osteoarthritis. Data collection was conducted from September 1 to October 31, 2019. The instruments were the Female Sexual Distress Scale (FSDS), the Female Sexual Function Index (FSFI), and the World Health Organization Quality of Life Assessment Instrument (WHOQLO) -BREF scale. Data were collected with structured questionnaires and analyzed using a t-test, ANOVA, Pearson's correlation analysis, and multiple regression analysis. A positive correlation was observed between sexual function and quality of life, whereas sexual distress had a negative correlation between sexual function and the quality of life. Factors affecting the quality of life of middle-aged women with osteoarthritis were sexual function, sexual distress, which explained 16.1%. Sexual distress, sexual function, and quality of life showed a correlation. Therefore, it is important to develop a nursing intervention that can improve the sexual function and reduce the sexual distress of middle-aged women with osteoarthritis to improve their quality of life.

Effect of Sociocultural Attitudes toward Appearance, Social Pressure and Stress on University Students' Body Figure Discrepancy (대학생의 외모 관련 사회문화적 태도 및 사회적 압박감, 스트레스가 신체상 불일치에 미치는 영향)

  • Lee, Eunmi;Kim, Yujeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.173-181
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    • 2017
  • This study was conducted to investigate the effects of sociocultural attitude toward appearance, social pressure, and stress on university students' body figure discrepancy. A total of 363 students were recruited from a university in C and A city. Data were collected by self-reported questionnaires from Oct 27 to Dec 9, 2016. Statistical analyses of the collected data were conducted using SPSS 20.0 and consisted of descriptive statistics, Pearson's correlation, and multiple regression. A positive relationship was observed between body figure discrepancy and female's sociocultural attitude toward appearance (r=.406, p=.006), peer pressure (r=.197, p<.001), parental pressure (r=.176, p=.002), and stress (r=.218, p<.001). Body figure discrepancies increased with peer pressure (${\beta}=.159$, p=.007), stress (${\beta}=.186$, p=.002), and BMI (${\beta}=.186$, p=.002), and these factors accounted for 10.9% of the body figure discrepancy. To reduce body figure discrepancy, it is necessary to develop health education and promotion programs that enable university students to manage weight and stress for health maintenance and to have positive self-assessment without being hurt by other people's view or evaluation.

Hospice Medicine and Nursing Ethics (호스피스의료와 간호윤리)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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A Study on the Simplification of Questionnaire for Sasang Constitution Classification(QSCC II) (사상체질진단검사(QSCC II) 설문지 간소화 연구)

  • Park, Jee-Won;Kim, Jeong-Ah;Wang, Myung-Ja
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.334-350
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    • 2003
  • The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

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Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Relation of Self-Perception of Halitosis According to Some Dental Hygiene Students's Oral Care Habits and Dietary Habits (일부 치위생(학)과 학생들의 구강관리습관과 식이습관의 구취자각 관련성)

  • Kim, Yea Hwang;Yun, Jung Won;Lee, Jung Hwa
    • Journal of Korean Clinical Health Science
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    • v.3 no.1
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    • pp.268-275
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    • 2015
  • Purpose. Most of halitosis is found by people than by themselves in their life. There are some people who are suffering from oral malodor psychasthenia although they do not have halitosis which may disturb social life by sociophobia. Methods. The subjects of this survey were the dental hygienic college students in Busan city and Gyeongnam province from December 1 to December 20, 2013, we use the 281 parts except for the 19 parts of a bad faith response of 300 parts. Results. As a response to the awareness of the halitosis of college students, "the smell became sometime" was highest in 63.3%, and tooth brushing of halitosis, In according to about awareness of halitosis brushing the number of cases showed a 73.4% increase when you answered "no" in case one day the number of brushing at least three times less than a minute halitosis awareness conducted brushing (p<0.05),in case of less than 1 minute brushing time, this was a statistically significant increase halitosis awareness (p<0.05). Conclusions. This study assessment the association between halitosis awareness and oral care habits was to provide students with the basis for education and counseling halitosis in clinical.