• Title/Summary/Keyword: Pain characteristics

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An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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Insomnia in Patients with Chronic Renal Failure on Hemodialysis (혈액투석 중인 만성 신부전증 환자에서의 불면증에 대한 연구)

  • Kim, Gyung-Ryul;Yang, Chang-Kook;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.126-132
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    • 1999
  • Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

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A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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Clinical Manifestations and Characteristics in Patients with Horseshoe Kidney (소아 및 성인 마제신 환자들의 임상적 특징과 비교)

  • Kim, Yu Kyong;Kwon, Nam Hee;Kang, Dong Il;Chung, Woo Yeong
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.73-78
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    • 2013
  • Purpose: We aimed to investigate the clinical characteristics and associated diseases in children with a horseshoe kidney and compared these data between children and adults. Method: We performed a retrospective analysis of the medical records and radiological findings of 43 patients diagnosed with a horseshoe kidney in the Busan Paik Hospital. The subjects were divided into the children's group (14 cases, age <18 years) and the adult group (29 cases, age ${\geq}18$ years). Results: The study group consisted of 17 males and 26 females with a median age of 34 years. In the children's group (14 cases), 5 subjects were male and 9 were female, with a mean age of $6.7{\pm}6.2$ years. Most of the subjects were asymptomatic and were incidentally diagnosed with horseshoe kidney during their evaluation for another disease. Among the associated diseases in the children's group, Turner syndrome was the most common (5 cases), whereas ureteropelvic junction (UPJ) stricture was observed in 2 cases (14.2%). None of the children exhibited abnormal renal function during the follow-up period. In the adult group (29 cases), 12 subjects were male and 17 were female, with a mean age of 48 years. Eighteen patients were incidentally diagnosed with horseshoe kidney during their evaluation for another disease, and 11 patients had hematuria or abdominal pain due to renal stones. Among the associated diseases in the adult group, Turner syndrome was the most common (5 cases), and UPJ stricture was observed in 5 cases; the other accompanying diseases included hydronephrosis and overactive bladder. Six patients exhibited decreased renal function (serum creatinine level >1.5) during the follow-up period. Conclusion: Horseshoe kidney is usually diagnosed incidentally in both children and adults. In the present study, we noted that Turner syndrome was the most common associated disease in children. In addition, most children were asymptomatic but had a high risk of urologic complications after the transition to adulthood. Therefore, children with horseshoe kidney require continuous follow-up.

A Study on Oriental Medical Diagnosis of Musculoskeletal Disorders using Moire Image (Moire 영상을 이용한 근골격계 질환의 한의학적 진단에 관한 연구)

  • Lee Eun-Kyoung;Yu Seung-Hyun;Lee Su-Kyung;Kang Sung-Ho;Han Jong-Min;Chong Myong-Soo;Chun Eun-Joo;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.72-92
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    • 2000
  • This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.

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An Exploratory Study of Hospice Care to Patients with Advanced Cancer (암환자를 위한 호스피스 케어에 관한 탐색적 연구)

  • Park, Hye-Ja
    • The Korean Nurse
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    • v.28 no.3
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    • pp.52-67
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    • 1989
  • True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

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Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) (편두통의 전 단계인 소아기주기성증후군의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용)

  • Park, Jae Yong;Nam, Sang-Ook;Eun, So-Hee;You, Su Jeong;Kang, Hoon-Chul;Eun, Baik-Lin;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.557-566
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    • 2009
  • Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

The Study about 「The Discourse on the Constitutional Symptoms and Diseases」 of Sasangin on the 『Dongyi Suse Bowon』 (『동의수세보원(東醫壽世保元)』 태소음양인(太少陰陽人)의 「병증론(病證論)」에 관(關)한 연구(硏究))

  • Lee, Su-kyung;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.1-26
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    • 1999
  • This paper was written in order to understand each constitutional symptoms and diseases with two aspects. The first was to trace the courses to accomplish constitutional symptoms and diseases from that of oriented medicine through "Dongyi Bogam" and the original writing such as "Shanghanlun". The second was to analyze the constitutional diseases with Lee Je-ma's own recognition on human being and the society which was based on the "Dongyi Suse Bowon". The original concepts of 'The Interior Disease' and 'The Exterior Disease' were based on the Nature and the Emotion, the Environmental Frames and the Human Affairs, the Ears Eyes Nose Mouth and the Lung Spleen Liver Kidney. The exterior disease were caused by the abilities of ears to listen, eyes to see, nose to smell, and mouth to taste on the environmental frames which were related one's recognition to society. The interior diseases were caused by the abilities of lung to study, spleen to ask, liver to think, kidney to judge on human affairs which were related the relationship between me and others. So the titles of constitutional diseases were named by these views on his first writing of "Dongyi Suse Bowon" in 1894. So the titles of Taeyangin diseases, 'The lumbar Vertebae Disease Induced by Exopathogen' and 'The Small Intestine Disease Induced by Endopathogen' were still remained as the first writing. But the titles of constitutional diseases were rewritten such as present titles in 1900. In order to express pathology and mechanism of constitutional diseases exactly, he rewrote titles which contained the manifestation sites of diseases, and the symptoms of febrile and cold, and the different congenital formations of organs. The exterior diseases and interior diseases had three characteristics. The first was that the exterior disease injured by the nature which had a tendency to progress slowly and the interior disease injured by the emotion which had a tendency to progress rapidly. The second was not that the interior disease and the exterior disease were separated, but that one influenced the other and these were revealed as a disease together when the diseases continued for a long time. The third was that even though the disease caught together it was included the beginning disease. The symptoms in ordinary times was the origin and clue to recognize the constitutional symptoms and diseases. It enabled to establish the constitutional medicine which treated by different ways according to constitution. It had two characteristics which were different from the Traditional Chinese Medicine in appearance of diseases. The first was that the disease was progressed to the next step from the symptoms in ordinary times. The second was that each constitution had different symptoms which were due to symptoms in ordinary times under the same disease, The third was the manifestation of disease were different from symptoms in ordinary times in the same constitution. But the most important thing was that Lee Je-ma recognized these symptoms in ordinary times as four categories and he presented constitutional symptoms and constitutional disease. The four categories were the method to recognize the human being and the diseases for him As the symptoms and diseases of Sasang Constitutional Medicine were compared to Traditional Chinese Medicine, the constitutional diseases of "Dongyi Suse Bowon" could be classified into two groups. The first group was the unique diseases and symptoms, which were not in the Traditional Chinese Medicine, and which were established by the Lee Je-ma. These contained the diseases of taeyangin, the exterior disease of taeumin, the exterior disease of soyangin. The second group used the unique methods to treat disease, which were not in Traditional Chinese Medicine, and which were established by Lee Je-ma. This contained the interior disease of taeumin, the delirium diseases from the MangYin of soyangin, the treatment to help the Yang-Qi ascend and to supplement the ql In the exterior disease of soeumin. Especially, the diseases of taeyangin and taeumin which were caused by the metabolism disorders of Qi-Yack(氣液) were the great achievement to establish constitutional symptoms and diseases. The discourse of taeyangin diseases presented his original thought to recognize the symptoms and diseases through the Shin Gi Hyul Jeong(神氣血精) and the Qi-Yack, the discourse of taeumin diseases presented the disperse of Qi-Yack through the forward and backward of sweat, the discourse of soyangin disease presented the sweat of hand and feet which was manifested that yin-qi of spleen descended to yin qi of kidney, and the bowel movement which was manifested that yang qi of large intestine ascend to head, face and four extremities, the discourse of soeumin disease presented the Jueyin syndrome without the abdominal pain and diarrhea as the exterior disease and made importance to the nervous mind And the classification of exterior diseases and interior diseases were not due to the pharmacology but due to the symptoms and diseases according to the constitution.

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The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital (말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석-)

  • Lee, Young-Sook;Heo, Dae-Seog;Yun, Young-Ho;Kim, Hyun-Sook;Choi, Kyung-Sook;Yun, Yeo-Jung
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.56-64
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    • 1998
  • Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

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