• Title/Summary/Keyword: Outpatient Clinics, Hospital

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Feasibility Study of Docetaxel and Cyclophosphamide Six- Cycle Therapy as Adjuvant Chemotherapy for Japanese Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Patients

  • Abe, Hajime;Mori, Tsuyoshi;Kawai, Yuki;Tomida, Kaori;Kubota, Yoshihiro;Umeda, Tomoko;Tani, Tohru
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4835-4838
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    • 2013
  • Background: We compared treatment completion rates and safety of docetaxel and cyclophosphamide sixcycle therapy (TC6) with docetaxel followed by 5FU, epirubicin and cyclophosphamide (T-FEC) therapy in Japanese patients with human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Materials and Methods: We administered TC6 q3w or T-FEC q3w to HER2-negative breast cancer patients. The primary endpoint of this trial was toxicity. As second endpoints, the treatment completion rate and relative dose intensity were evaluated. Results: The TC6 and T-FEC group consisted of 22 and 21 patients, respectively. Concerning hematological toxicity, grade 3 or higher adverse reactions included neutropenia and febrile neutropenia. As non-hematological adverse events, exanthema and peripheral neuropathy were frequently reported in the TC6 group, whereas more patients of the T-FEC group reported nausea and vomiting. In TC6, the treatment completion rate was 86.4% and the relative dose intensity of docetaxel was 93.2%. In T-FEC, the values were 95.2% and 98.9%, respectively. Conclusions: These results suggest that TC6 is tolerable in Japanese, and that this regimen can also be performed in outpatient clinics. However, with the TC6 regimen, the compliance was slightly lower than with the T-FEC regimen, and supportive therapy needs to be managed appropriately.

Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

  • Omran, Suha;Barakat, Husam;Muliira, Joshua Kanaabi;Bashaireh, Ibrahim;Batiha, Abdul-Moni'm
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4229-4235
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    • 2015
  • Background: Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. Materials and Methods: A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. Results: Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. Conclusions: Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

Parental concerns about their premature infants' health after discharge from the neonatal intensive care unit: a questionnaire survey for anticipated guidance in a neonatal follow-up clinic

  • Cho, Ji-Yun;Lee, Ju-Young;Youn, Young-Ah;Kim, Soon-Ju;Kim, So-Young;Sung, In-Kyung
    • Clinical and Experimental Pediatrics
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    • v.55 no.8
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    • pp.272-279
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    • 2012
  • Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

Effects of Tai Chi or Self-help Program on Balance, Flexibility, Oxygen Consumption, and Muscle Strength in Women with Osteoarthritis (골관절염을 가진 여성의 균형감, 유연성, 심폐기능 및 근력에 대한 타이치 운동과 자조관리 프로그램의 효과비교)

  • Song, Rha-Yun;Lee, Eun-Ok;Lam, Paul;Bae, Sang-Cheol
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.1
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    • pp.30-38
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    • 2009
  • Purpose: This randomized study was done to compare the effects of a 6 month Tai Chi exercise and a self-help program on balance, flexibility and muscle strength in women with osteoarthritis (OA). Method: In this experimental study, 82 women with OA recruited from outpatient clinics or community health centers were randomly assigned either to a Tai Chi group or a self-help group. Thirty women (mean age = 62 years) in the Tai Chi group and 39 (mean age = 59 years) in the self-help group completed posttest measures (balance, flexibility, oxygen consumption, abdominal muscle strength, back muscle strength, and grip strength) at 6 months. Results: After the 6 month, Tai Chi participants had significantly greater balance (mean difference = 2.9 vs. 0.9 for the self-help), grip strength (mean difference = 4.6 vs. 0.9 for the self-help), and back muscle strength (mean difference = 4.1 vs. -0.3 for the self-help). However, flexibility, oxygen consumption, and abdominal muscle strength were not significantly different between the groups. Conclusion: Tai Chi increased balance, grip strength and back muscle strength in older women with osteoarthritis compared to the self-help program. Whether these changes improve physical functioning and fall prevention requires further study.

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A Clinical Survey of the Patients in Neuro-Pain Clinic at Ajou University (신경통증클리닉 환자의 1년간 통계고찰)

  • Park, Eun Jung;Han, Kyung Ream;Kim, Do Wan;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.181-185
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    • 2007
  • Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.

Posttraumatic Growth in Family Caregivers of Patients with Cancer (암환자 가족돌봄자의 외상 후 성장)

  • Choi, Soon Ock
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.1-9
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    • 2014
  • Purpose: The purpose of this study was to examine posttraumatic growth (PTG) in family caregivers of patients with cancer. Methods: Participants included 201 family caregivers of cancer patients who are treated at outpatient clinics and oncology wards of a university hospital and two general hospitals in Busan, Korea. The study instrument was the Korean version of the posttraumatic growth inventory (K-PTGI). Data were analyzed with descriptive statistics, t test, one-way ANOVA and Scheffe's test using the SPSS 21 for Windows. Results: The mean score of PTG was 3.10. The factor with the highest score was "Changes to self-perception" (3.15), while the one with the lowest was "Increase in spiritual interest" (2.88). There were significant differences in PTG, depending on age, religion, importance of religious life and perceived level of daily difficulties. Conclusion: Family caregivers also experience PTG when their loved ones are diagnosed with cancer. According to these findings, it is necessary to develop a spiritual nursing program to help family caregivers growth from the experience of attending patients with cancer.

Post-Traumatic Stress Disorder Symptoms and Quality of Life of Patients with Coronary Artery Disease (관상동맥질환자의 외상 후 스트레스장애 증상과 삶의 질)

  • Lee, Seung Ah;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.82-93
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    • 2019
  • Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

Analysis of Factors Related to the Use of Korean Medicine Treatment in Patients with Mood Disorders: Based on 2019 Korea Health Panel Annual Data (기분장애 환자에서 한의치료 이용과 관련된 요인분석: 제2기 한국의료패널 자료를 중심으로)

  • Kyoungeun Lee;Chan-Young Kwon
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.349-358
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    • 2023
  • Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.

Pulp stones: any relevance with the levels of serum calcium, parathyroid hormone, vitamin D and uric acid

  • Ceyda Gurhan;Ercan Saruhan
    • Restorative Dentistry and Endodontics
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    • v.49 no.2
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    • pp.17.1-17.8
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    • 2024
  • Objectives: This study evaluated the effect of serum calcium, parathyroid hormone (PTH), vitamin D, and uric acid levels on pulp stone formation. Materials and Methods: Patients who were admitted to the Muğla Sıtkı Koçman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology for dental complaints were registered. Among these patients, individuals who had routine biochemical tests at the same period in the Outpatient Clinics of Muğla Sıtkı Koçman University Training and Research Hospital were included in the study. The patients with at least 1 pulp stone on panoramic radiographs recorded as the "pulp stone group" while patients without any pulp stones were the "control group". Demographic data and serum levels of calcium, PTH, vitamin D, and uric acid were retrospectively evaluated in both groups. Student t-test or Mann-Whitney U test was used to evaluate the differences between the groups. Results: Among 151 patients, dental pulp stone was detected in 53.6% of patients, and 82.7% of these patients were female. Female sex and pulp stone formation were significantly associated (p = 0.001). The mean age of the pulp stone group was 43.9, while it was 39.9 in the control group, without any significant correlation between age and pulp stone (p > 0.05). Similarly, there were no significant differences in serum levels of PTH, vitamin D, uric acid and calcium between groups (p > 0.05). Conclusions: According to the present study, the effect of dental factors rather than systemic factors should be considered primarily in pulp stone formation.

A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services (치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석)

  • 홍여신;박현애;조남옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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