• The Journal of the Convergence on Culture Technology
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• v.4 no.1
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• pp.57-65
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• 2018

The purpose of this study was to investigate the factors affecting the actual condition and effectiveness of orthodontic treatment among some dental hygienists and students. This study was carried out from September to December, 2016 to describe the purpose of the study and the method of writing the questionnaire for some dental hygienists and students. The final 430 sections were analyzed and analyzed using PASW Statistics 18.0. First, the duration of orthodontic treatment was 34.4% for college students, 36.9% for orthodontic treatment for less than 2 ~ 3 years, and 62.3% for internal motivation. The factors affecting the orthodontic treatment effect were the patient's cooperativeness and the hospital's scale was the lowest. The higher the grade level, the more the clinical experience and dental part-time experience were, the higher the correlation between dental specialty and dental hygienist's medical service, education and counseling was .521(P<0.001). The higher the level of cooperation, the higher the grade level, the more dental treatment and orthodontic treatment experience, the lower the level of family co - operation. Therefore, it is important to emphasize the importance of cooperation of orthodontic patients and to develop a strategic program for each individual patient.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.585-591
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• 2010

Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

• The Journal of the Korea Contents Association
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• v.19 no.11
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• pp.603-618
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• 2019

This study aims to explore the meaning and nature of the nursing experience of visiting nurses of home-based long-term care service centers by using van Manen's hermeneutic phenomenological approach. A total of 10 home-visiting nurses working in Seoul and Gyeonggi-do Province were recruited through purposive, convenience, and snowball sampling and participated in the study. Data were collected from January 7, 2017 to October 12, 2018 through in-depth individual interviews with the participants. The analysis resulted in 6 essential themes regarding the lived experience of visiting nurses: 'establising a good rapport with the patient and his or her family caregiver', 'building the foundation of visiting nursing by performing autonomously nursing procedures for the patient', 'facing the reality not to be able to work as much as I want due to the limitations of the support system in performing work as a visiting nurse', 'upset when sincerity could not be delivered', 'following the calling of medical personnel by taking responsibility for 'my patient', and 'pledging oneself to career-long work, feeling reward as a visiting nurse.' The findings of the study help understand the role and importance of visiting nurses and contribute to the preparation of practical measures to improve the quality of home-visiting nursing.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.47-55
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• 1998

Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.303-309
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• 2016

Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.9-19
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• 2002

This study was conducted to compare the health behaviors of patient s before and after a stroke and propose health education program to reduce risk factors related to stroke recurrence. Data were collected from eighty- eight stroke patients registered at the Gyeongju-si Health Center between July 1, to August 30, 1999, by interviewing patients from a prepared structured questionnaire, which included questions on that patients ' general characteristics, health- related behaviors, family-related characteristics, and pre- and post - stroke health status. Smoking rate of 51.1% before stroke reduced to 25.0% after stroke; drinking rate of 52.3% before stroke reduced to 17.0% after stroke; daily smoking amount of 20.1 packs per day before stroke significantly reduced to 14.9 packs per day after stroke; and daily drinking amount of 92.4ml before stroke significantly reduced to 23.7ml after stroke. Smoking rate according to sex showed a marked decrease in the male subjects, but 31.6% still smoked even after their stroke. Among the female subjects, smoking rate of 16.1% before stroke reduced to 12.9% after stroke. Observation of the change in health- related behaviors of stroke patient s showed significant change in smoking rate, drinking rate and intake of regular meals etc. of patient s with a spouse and patients who received preventive health education. Health education on quitting smoking, temperance, low fat diet, exercise and regular meals for stroke patient s are needed, and public and private organizations can do their part in development and providing continuing health education programs and health education.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.23 no.3
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• pp.122-137
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• 2010

Objective : Atopic dermatitis (AD) in children may profoundly affect the quality of life (QOL), and also cause financial burden, to the families of those suffering from this ailment. The aim of our study was to examine the quality of life and the financial burden of atopic dermatitis in children and their families to evaluate this relationship with the degree of AD. Methods : 37 infant and child atopic dermatitis patients were included and evaluated using the SCORing of Atopic Dermatitis (SCORAD) Index and Eczema Area and Severity Index (EASI). Patients and carers were asked to fill in the questionnaires about their quality of life and financial costs during the past year. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation was used for statistical analysis. Results : 1. The mean score of Children's Dermatology Life Quality Index (CDLQI) was $10.52{\pm}4.82$, Infants' Dermatologic Quality of Life (IDQOL) was $8.21{\pm}3.95$. 2. The mean score of Family Dermatology Life Quality Index (FDLQI) was $13.30{\pm}5.72$, Dermatitis Family Impact (DFI) was $12.5{\pm}4.98$. 3. By analyzing the questionnaire, the monthly average cost was determined to be 730,800 won for each patient : the direct cost was 283,500 won, and the indirect cost was 447,300 won. 4. By analyzing the correlation between the severity of AD and QOL, subjective SCORAD were significantly and positively correlated with QOL(IDQOL, FDLQI, DFI, CDLQI). 5. By analyzing the correlation between the severity of AD and any economic impact, EASI were significantly and positively correlated with the direct cost. Conclusion : The above results show that the QOL of the patients and carers is significantly related to their disease severity. Atopic dermatitis patients pay an average of 730,800 won a month, and the economic impact on the patients is significantly related to their disease severity. The CDLQI, IDQOL, FDLQI and DFImay potentially be of value to help in the appropriate management of AD and can be used as an added measurement in clinical trials involving AD management.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Quality Improvement in Health Care
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• v.3 no.2
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• pp.60-68
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• 1997

Background : Medical records are used to assess clinical performance of physicians and quality of care. The contents which are written in medical records are considered as the objective evidences to know what the doctors think about the patient's problems. But the problem to use medical records as the assessment tools is the incompleteness of medical recording. The purpose of this study is to know if the completeness of medical recording is correlated to quality of care for inpattients and it can predict physicians's quality of care. Method : 32 clinical physicians reviewed 200 patients' medical records who were selected randomly from the inpatients who were admitted to the university hospital during July, 1995 and June, 1996. The reviewers used the structured evaluation questionnaires which were composed of two part. One part evaluated the completeness of the medical recording and the other evaluating appropriateness of diagnosis and treatment processes. We summated the scores of each items and calculated percentile scores. Results : The mean percentile score of completeness of the medical recording was 67.9% in 1995 and 79.8% in 1996. The mean percentile score of appropriateness was 52.2% in 1995 and 69.5% in 1996. This change between 1995 and 1996 was statistically significant. In non-surgical patients, the percentile scores of the completeness and those of the appropriateness were correlated positively and this correlation was statistically significant(p<0.05). In surgical patients, the positve correlation between the completeness and the appropriateness was also statistically significant(p<0.05). Discussion : In conclusion, the completeness of medical recording is considered as the good predictor of the quality of care for inpatients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.21-25
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• 2012

The use of complementary and alternative medicines (CAM) among women with gynecologic cancer is becoming increasingly popular. Therefore, it is important to gain insight into the prevalence and factors related to the use of CAM. The aim of this study was to assess the use of CAM in women with gynecologic cancer. This is a descriptive cross-sectional study. Data were obtained from 67 gynecological cancer patients at gynecologic oncology clinic of a hospital in Turkey between October 2009 to December 2010 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage. On the basis of women's responses, all participants were divided into 2 groups: CAM users and nonusers. The findings indicated that 61.2% of the women reported the use of 1 or more CAM therapies. There were no significant differences in the sociodemographic and clinical characteristics between CAM users and nonusers (P <0.05). The most frequently used CAM method was herbal therapy (90.2%) and the second was prayer (41.5%). The main sources of information about CAM were informal (friends/ family members). A considerable proportion (56.1%) of CAM users had discussed their CAM use with their physicians or nurses. Turkish women with gynecologic cancer frequently use CAM in addition to standard medical therapy. Nurses/ oncologists caring for women with gynecologic cancer should initiate a dialogue about usage of CAM, discussing the potential adverse effects of CAM and the patient's therapeutic goals.