• Title/Summary/Keyword: Patients' relatives

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Beyond Medical Bills: High Prevalence of Financial Toxicity and Diverse Management Strategies Among Vietnamese Patients With Cancer

  • Binh Thang Tran;Thanh Gia Nguyen;Dinh Duong Le;Minh Tu Nguyen;Nhan P. T. Nguyen;Minh Hanh Nguyen;The Due Ong
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.4
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    • pp.407-419
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    • 2024
  • Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

A Survey of Utilization of Complementary Alternative Medicine in Diabetes Mellitus (당뇨병 환자의 대체요법 경험실태에 대한 조사 연구)

  • 이명숙
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.7-19
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    • 2001
  • In our country, patients with diabetes mellitus are searching for complementary treatments to recover from illness, while they received treatments from the doctor. However, have been evaluated or investigated systematically. This study was carried out to explore application of complementary treatments for patients with DM. For this survey, questionnaires were developed by researchers and the data was collected from July to October of 1999. Among the 223 subjects, there is one general hospital, one oriental hospital, 15 area C.H.P, ahd 2 area health centers. The results were as follows: 1. The total number of cases was 223 and the average age was 62.85 years old and average duration of DM was 8.1 years. The number of patients who had experience with alternative therapies was 145 (65%). The number of those who have not undergone treatments was 78 (35%). 2. The 43.5% of experienced CAM were advised family and relatives. Only 30.3% approved the effect of CAM and 52.5% said that If another a new CAM is introduced, they will try it. 4. Ninety three kinds of complementary treatments were used. Among the used items, 63.7% was various types of plants, 21.6% was animal material and 14.7% was the mixed group. As a single item, Bombyx Mori (Silkworm) was the most frequently used (10.5%) followed by the bean, mushroom, Morus bombycis (mulberry), Ginseng, Commelina Communis (Dalgaebi), Chinese medicine, root of Rosa rugosa (Haedangwha). 5. Among the used items, Trichosanthes kirilowii Max. Eucommia ulmoides Oliver, Commelina Communis, Aralia elata, pine needle, mulberry fruit, root of Rosa rugosa. Ginseng, Lycii Fructus, Dioscorea radix, Polygonatum odoratum, Cassia tora L, Bombyx Mori, loach, Crucian carp were based upon the pharmacological function of effect for control of diabetes mellitus symptom. 6. In the analysis of the relationships between the general characters of the patients with new complementary alternative medicine try and hospital treatment; 1) The shorter group suffered from DM (p=.038), poor Self-MBG (p=.037) and wanted to try new complementary alternative medicine. 2) The group of DM education experience were carried out hospital treatment well (p=.045). In conclusion, further study will be required for the patients experience using alternative therapies as the D-M in terms of holistic view of patients.

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Recognition of Atopic Dermatitis, Asthma and the Snack Intake Status among Middle School Students in Seoul (서울 일부 지역 중학생의 아토피피부염 및 천식에 대한 인식과 간식 섭취 실태)

  • Park, Yong-Soon;Song, Ji-Hyeon;Won, Sun-Im
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.4
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    • pp.485-498
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    • 2011
  • The aim of this study was to acquire information related to recognition of atopic dermatitis, asthma, and snack intake status among middle school students in the Seoul area. The survey was carried out by self-questionnaires on 535 students in the 2nd and 3rd grade (88 Patients: atopic dermatitis and asthma group and 428 Control: healthy group). All data were analyzed using SPSS (version 13.0) software. The results were as follows: Among patients, females (61.4%) had a significantly higher prevalence of symptoms than males (38.6%) (p<0.001). Body mass index was not significantly different between the patients and Control group. The most common source for obtaining information about atopic dermatitis and asthma was 'TV or radio' (38.4%), followed by 'family members or relatives' (27.3%) in patients, but 'Internet' (22.2%) was most common in the control group (p<0.05). Although awareness of atopic dermatitis and asthma was similarly low between the two groups, patients had a higher percentage of correct answers on atopic knowledge (p<0.05). However, there was no significant difference in knowledge of asthma between the two groups. Frequency of snack intake was significantly lower in patients (p<0.05), and consumption of sundae, fried food, liquefied fermented milk, hamburger, pizza, and french fries was also significantly lower (p<0.05). The reason of selecting snacks was mainly 'taste' in both groups. In conclusion, education regarding atopic knowledge and appropriate snack selection is necessary for students with atopic dermatitis or asthma.

Detection of Germline Mutations in Argentine Retinoblastoma Patients: Low and Full Penetrance Retinoblastoma Caused by the Same Germline Truncating Mutation

  • Dalamon, Viviana;Surace, Ezequiel;Giliberto, Florencia;Ferreiro, Veronica;Fernandez, Cecilia;Szijan, Irene
    • BMB Reports
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    • v.37 no.2
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    • pp.246-253
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    • 2004
  • Constitutional RB1 gene mutations were studied in a series of 21 families with unilateral and bilateral retinoblastoma patients. Peripheral blood lymphocytes were analyzed by "exon by exon" PCR-heteroduplex and sequencing. Mutations were identified in 6 (29%) of the patients. One mutation corresponded to an intronic polymorphism in g.174351T > A. The other five mutations resulted C to T exonic transitions, four were CGA sequences (g.65386, g.150037 in two patients, and g.162237), creating stop codons and presumably truncated proteins. The fifth one was new and resulted in alanine to valine substitution (g.73774). Two patients had the same the germline truncated mutation (g.150037C > T), one with a familial bilateral early onset retinoblastoma and one with a sporadic unilateral late onset retinoblastoma. The later type has not been previously described. This finding is discussed in the genotype/phenotype correlation context. Additionally, a single nucleotide change was found in six studied samples, where a C to T homozygous transversion was identified in intron 26 (IVS26 + 28). It is worthy the non concordance of the nucleotide with the published sequence. This analysis proved to be a useful method for the detection of mutations in the RB1 gene, and contributed to the adequate genetic counseling to patients and relatives.

Doctors' Opinions on Lung Cancer Treatment (폐암의 치료에 관한 일반 의사들의 견해)

  • Bae, Mun-Seop;Park, Jae-Yong;Cha, Seung-Ick;Chae, Sang-Chul;Kim, Chang-Ho;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.507-516
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    • 1999
  • Background : Patients with lung cancer and their relatives often ask the advice of relative or friends who are doctors on the treatment and prognosis of the disease. Therefore a doctor's opinion may play a role in determining the treatment modality and affect therapeutic compliance of patients. The purpose of this study was to find the opinion of general practitioners on lung cancer treatment. Method : A mail survey for general practitioners in Taegu City and Northern Kyungsang Province was performed. Each individual was sent a written questionnaire in which he or she was asked for ten questions about management and prognosis of lung cancer. Results : Two hundred and twenty eight doctors filled in the questionnaire. Of the respondents, 68% had the experience of being asked about lung cancer by their friends or relatives. About 52% replied that it was better to tell the patient of his or her disease. And about 22% considered it better to follow the relatives' opinion. On the question about choosing the treatment modality, following the doctors' plan was most appropriate in 86.9%, showing that most respondents favored actively recommending doctors. Nonsurgical treatment was preferable in patients over 80 years old with resectable lung cancer and with an increase in age, significant increase was observed in respondents recommending nonsurgical treatment. Most respondents said that they would actively recommend or advise following the doctors' plan about radiotherapy and chemotherapy. But a large percent of the respondents had a negative view on the effect of radiotherapy and chemotherapy. Conclusion : The opinions of general practitioners on the treatment and prognosis of lung cancer was variable. And they did not prefer active treatment for patients with old age or advanced lung cancer.

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Clinical Charicteristics of Primary Lung Cancer Patients in a Tertiary Hospital (3차 의료기관에서 진단된 원발성 폐암의 임상적 특성)

  • Ryu, Jeong-Seon;Lee, Hun-Jae;Leem, Jong-Han;Kim, Lucia;Lee, Kyung-Hee;Cho, Jae-Hwa;Yoon, Young-Han;Kwak, Seung-Min;Lee, Hong-Lyeol;Kim, Kwang-Ho;Loh, John-Kyu;Jung, Soo-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.321-329
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    • 2006
  • Background : To evaluate the clinical characteristics of lung cancer patients in Korea, where there is a higher number of smokers than in Western countries. Methods : A retrospective study was performed on 1655 lung cancer patients, who were diagnosed at a university hospital between September 1996 and August 2005. Age, gender, cell types and clinical stage were analysed. Of 941 patients, who responded to a questionnaire at the time of diagnosis, the smoking habits, occupational history, family history of lung cancer in the first-degree relatives, coexisting diseases (diabetes mellitus and cardiovascular disease), body weight loss, ECOG performance status and presenting symptoms, were examined prospectively. In addition, coexisting diseases including chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis and active pulmonary tuberculosis were evaluated. Results : Of the 1655 patients, the male to females ratio was 3.6. Squamous cell carcinoma was the most common cancer whereas adenocarcinoma was more common in lifetime nonsmokers or women. 19.9% of the patients were non smokers and 80.1% ever smokers. Since 2000, there was an increase in the incidence of adenocarcinoma with a corresponding decrease in the incidence of squamous cell carcinoma. 6.2% of patients were asymptomatic. A coincident diagnosis of chronic obstructive pulmonary disease, cardiovascular disease, diabetes mellitus, active pulmonary tuberculosis, and idiopathic pulmonary fibrosis was made in: 44.1%, 22.2%, 10.7%, 3.9%, and 1.6% of patients, respectively. A positive family history of lung cancer in the first-degree relatives was identified in 4.4% of patients. An occupational history relevant to lung cancer was identified in 12.2% of patients. Conclusion : There is a high proportion of cigarette smokers in Korean lung cancer patients. The most common cell type was squamous cell carcinoma. However, a more detailed, prospective study of the clinical characteristics will be needed to better characterize lung cancer in Korea.

A Study on Status and Subjective Recognition of Functional Foods Among Diabetic Patients (당뇨병 환자의 건강기능식품에 대한 이용 실태 및 주관적인 인식에 관한 조사)

  • Park, Yeong-Mi;Son, Jeong-Min;Jang, Hak-Cheol
    • Journal of the Korean Dietetic Association
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    • v.11 no.2
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    • pp.216-222
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    • 2005
  • In Korea, there are many kinds of functional foods to manage diabetes, however, they have not been evaluated or investigated systematically. The purpose of this study was to investigate the status of recognition and intake of functional foods among diabetic patients. The study subjects were 307 patients(male 135, female 172), who diagnosed with type 2 diabetes at Seoul National University of Bundang Hospital. Questionnaire survey was done from July to October, 2004 for the characteristics of patients and factors related to the use of functional foods. The mean age of the subjects was 64$\pm$10.2 years, and the mean duration of disease was 9.5$\pm$8.90 years. Approximately 49.8% of the subjects had experience to use functional foods at least once in past. Total number of functional foods used were 56 types. Red ginseng was used most frequently(27.9%), then followed by Silkworm powder(13.6%), Vitamin supplements(10.4%), Mulberry tree(7.1%), Cordyceps sinensis(6.8%) and Ginseng(4.2%). Functional foods were introduced by their friends.relatives(38.4%), family(29.1%), internet(13.9%), and the mass media(10.6%). Among respondents, 94.7% took functional foods with conventional diet therapies(diet, exercise and medication). The purpose of functional food use was to control blood glucose level(49.0%), to relieve fatigue and improve stamina(19.9%), to treat and prevent a disease(17.2%) and to help blood circulation(7.9%). Upon the question of further recommendation of functional foods to others, 74.8% of the subjects answered negative response. However, 12.6% of the subjects showed the further intention of using new product. Therefore, to guide the appropriate use of functional foods for diabetic patients, diabetic educator should provide the knowledge of the efficacy of functional foods and the desirable guidelines.

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A Study on Support by Families of Patients with pulmonary Tuberculosis and Compliance with Sick Role Behavior (결핵 환자의 가족 지지와 환자 역할 행위에 관한 연구)

  • 서숭미
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.555-568
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    • 1993
  • The purposed of this study was to identify compliance with sick role behavoir and support by families of patients with pulmonary tuberculosis and to identify factors affecting these variables md factors that increase compiance with sick role behavoior This study was a survey design done in K. general hospital from 1992. 7 1 to 1992. 7. 20. The data were collected through personal interviews with 70 subjects who had pulmonary tuberculosis. A questionnaire was used to collect the data. 1. Demographic characteristics of the subjects The factor causing the tuberculosis for 28.6% of the subjects was that they lived with another family member who had pulmonary tuberculosis, 11.4% of the subjects had a family member who died of tuberculosis, 24.3% of the subjects had experienced an adverse reaction to medication. Gastroenteric disorders(28.6%) had the highest rate for this kind of adverse reaction to medication. 2. Support by families for patients with pulmonary tuberculosis The items which showed high support for compliance were taking medicine regularly(80.0% ) eat-ing a balanced diet(80.0%), loving them(84.3%), taking care of them(82.8%), getting the support from people for being sick(81.1%) The items which showed low support for compliance were meeting relatives or clergymen(20%), talking with the people suffering from pulmenary tuberculosis to relieve frustrated because they were not recovering. 3. General characteristics and family support The degree of family support showed that 75 was highest score and 30, the lowest score with 55.5(74. 1%)the average score. The degree of family support appeared similar in cases where the person was married and where the person did not have a family member with pulmonary tuberculosis(P〈.01) 4. The degree of compliance with sick role behavior by patients with pulmonary tuberculosis The degree of compliance with sick role behavior showed that 100 was the highest scoure47, the low-est score and 76.4, the average score out of a Possible score of 100. 5. Correlation between compliance with sick role behavior and family support The compliance with sick role behavior and family support showed a positive correlation(r=.2094 p〈.5) So for patients with pulmonary tuberculosis. compliance with sick role behavior is related to the sup-port given by their families.

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호스피스 환자의 임종증상

  • Choe, Hwa-Suk;Kim, Su-Ji
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.75-86
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    • 2002
  • Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.

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Health Care Utilization of Outpatients in the Oriental Hospital (모 한방병원 내원 환자의 의료이용실태)

  • 김지용;김경호;김장현
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.129-137
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    • 2000
  • Objectives: The aim of this study was to investigate the attitude toward the oriental hospital among 1,234 outpatients. Methods: A questionnaire about the general characteristics of patients, the decision-maker of use and the reason of choice or alteration was implemented. Results: The results of this survey as follows: Among outpatients 56.4 % were female in sex, 25.6 % were below 9 years of age; in educational level, 50.1 % were college graduates. Among outpatients, 33.6% chose the oriental hospital as their first choice and the rest were recommended by other persons. The recommenders were mostly relatives(73.9 %), female(73.4 %), young(30-39 years old, 40.1 %), high educational level (above the college, 54.9 %) people. 37.8 % among outpatients were secondary selection after the western medical clinic for the same symptom and sign. 7.0 % were the concomitant users of both therapies. 62.8 % among the concomitant users did not notify the western doctor about the dual therapies. The reasons they did not notify their Western doctors were 'be afraid of western doctor s bias' (42.6 %), 'no special reason' (29.6 %). Conclusions: The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and doctors who practice both kinds of medicine.

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