• Title/Summary/Keyword: Psychological symptom

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A Longitudinal Validation Study of the Korean Version of PCL-5(Post-traumatic Stress Disorder Checklist for DSM-5) (PCL-5(DSM-5 기준 외상 후 스트레스 장애 체크리스트) 한국판 종단 타당화 연구)

  • Lee, DongHun;Lee, DeokHee;Kim, SungHyun;Jung, DaSong
    • Korean Journal of Culture and Social Issue
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    • v.28 no.2
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    • pp.187-217
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    • 2022
  • The aim of this study is to examine the psychometric properties of the Korean version of the Post-traumatic Stress Disorder Checklist for DSM-5(PCL-5). For this purpose, online surveys were conducted for two times with a one year interval using the data from 1,077 Korean adults at time 1, and 563 Korean adults at time 2. First, from the result of the confirmatory factor analysis, comparing the model fit of the 1, 4, 6, and 7-factor model, the 4, 6, and 7-factor model showed a acceptable fit, and the best fit was seen in the order of the 7, 6, 4-factor model. Second, the internal consistency, omega coefficient, construct validity, average variance extracted, and test-retest reliability results were all satisfactory.. Third, a correlation analysis with the K-PC-PTSD-5 and the sub-factors of BSI-18 was conducted to check the validity of the Korean Version of PCL-5. As a result, a positive correlation was seen with both K-PC-PTSD-5 and BSI-18. Fourth, a hierarchical multiple regression was performed to examine whether the Korean Version of PCL-5 predicts future PTSD, depression, anxiety, and somatization. As a result, the Korean Version of PCL-5 measured at time 1 significantly predicted PTSD, depression, anxiety, and somatization symptoms at time 2. Fifth, by analyzing the ROC curve, the discriminant power of PCL-5 for screening PTSD symptom groups was confirmed, and the best cut-off score was suggested. As a result of the longitudinal validation of Korean version of PCL-5, it was found that this scale is a reliable and valid measure for Korean adults. By looking into the predictive validity of the scale, it was found that the Korean version of PCL-5 can predict not only PTSD symptoms but also PTSD-related symptoms such as depression, anxiety, and somatization. Also, this study differs from previous validation studies measuring PTSD symptoms in that it suggested a cut-off score to help differentiate PTSD symptom groups.

A Study on Correlations Among Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관 질환 환자에서 인지기능, 정신행동 증상 및 일상 생활 기능간의 상관에 대한 연구)

  • Lee, Young-Ho;Park, Young-Soo;Choi, Hong;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Suk-Hai;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.170-181
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    • 1996
  • Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

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The Influences of Stress Coping Strategy on Depression and Anxiety in Recipients of Hematopoietic Stem Cell Transplantation (스트레스 대처방식이 조혈모세포 이식 환자의 우울과 불안에 미치는 영향)

  • Yoon, Su-Jung;Lee, Chul;Lim, Seong-Hu;Chae, Jeong-Ho;Jun, Tae-Youn;Kim, Kwang-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.8-17
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    • 2002
  • Objective : Increasing in frequency and success of hematopoietic stem cell transplantation and improved survival rates have led to growing concerns regarding the psychosocial aspects of hematopoietic stem cell transplantation recipients. In this study, we have examined the stress coping strategies and related psychiatric symptom in the hematopoietic stem cell transplantation recipients. Methods : In this study, we examined the psychological stress symptoms of hematopoietic stem cell transplantation recipients and differences of psychosocial variables between active coping group and passive coping group. Twenty nine recipients of hematopoietic stem cell transplantation were recruited prospectively and assessed at 2 weeks pretranplant and at 1-2 days posttranplant. Thirty normal controls were recruited. Assessments included a psychiatric interview, a variety of standardized questionnaires (Ways of Coping Questionnaires, Perceived Stress Scale, Hospital Depression and Anxiety Scale, Short-Form 36 Health Survey). Results : Hematopoietic stem cell transplantation patients showed higher degree of depression (p<0.001) and anxiety (p=0.011) symptoms than normal control group. However, no differences of depression and anxiety symptoms between pretransplant and posttransplant status were showed. And, passive coping group showed higher degree of depression (p=0.046) and anxiety symptoms (p<0.001) than active coping group. Conclusions : Our results suggested that many hematopoietic stem cell transplantation recipients would exhibit severe to moderate symptoms of anxiety and depression. Also, it seemed likely that passive coping style might influence the development of negative affect such as anxiety and depression. The implications of these findings were discussed in terms of the need to monitor the coping strategies and apply the appropriate psychiatric intervention. And, further prospective studies about long-term survival and psychological adaptive functions of hematopoietic stem cell transplantation patients are recommended.

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Comparison of Myogenous and Arthrogenous Pain Patients of Temporomandibular Disorders using Research Diagnostic Criteria for Temporomandibular Disorders (측두하악장애 연구진단기준(RDC/TMD)를 이용한 측두하악장애의 근육성 동통과 관절성 동통 환자군의 비교)

  • Park, Joo Sun;Kim, Dong Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.233-242
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    • 2012
  • The purposes of this study were to compare psychological profiles, to investigate the differences in the clinical characteristics, and to compare treatment outcomes between myogenous pain and arthrogenous pain subgroups of temporomandibular disorder (TMD) based on Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD). Two hundred and fifty two patients diagnosed as TMD were divided into three groups based on the RDC/TMD axis I diagnostic guidelines; myogenous pain group, arthrogenous pain group, and mixed pain (both myogenous pain and arthrogenous pain) group. RDC/TMD history questionnaire was administered to each patient and depression, somatization, jaw disability, pain intensity, disability days, and graded chronic pain scale were analyzed. Bruxism, clenching, insomnia, headache, and unilateral chewing were assessed in a standardized TMD dysfunction questionnaire and the duration of onset, chronicity of pain, treatment period, the effectiveness of the treatment, and improvement of symptoms also analyzed. Myogenous pain group had higher depression (p=0.002), and somatization scales (p<0.001) than the arthrogenous pain group. Mixed pain group showed higher pain intensity (p=0.008), disability days (p<0.001), graded chronic pain scale (p=0.005), somatization (p<0.001), and depression scores (p=0.002) than the arthrogenous pain group. Jaw disability did not show any significant differences among the three groups (p=0.058). Arthrogenous pain group reported more limitation of mouth opening than myogenous pain group (p=0.007). Duration of onset showed that the arthrogenous pain group had lowest prevalence of chronicity among three groups (p=0.002). Mixed pain group patients showed lowest symptom improvements among three groups (p=0.007). Multiple linear regression analysis results showed that the treatment effectiveness was significantly associated with somatization score (${\beta}$=-0.251, p=0.03).

A Study on the Differences of Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions According to the Lateralization of Lesion in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 병소의 편측성에 따른 인지기능, 정신행동증상 및 일상생활기능의 차이에 대한 연구)

  • Park, Young-Soo;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Suk-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.56-67
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    • 1996
  • Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

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Physiological and Psychological analysis of musculoskeletal symptoms (근골격계질환에 대한 물리적/심리적요인에 대한 연구)

  • Donghyun Park;Sung Kyu Bae
    • Korean Journal of Culture and Social Issue
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    • v.9 no.spc
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    • pp.107-122
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    • 2003
  • The object of this study is to evaluate the prevailing physical and psychosocial conditions regarding occupational low back injury. This study consists of two parts. In the first part of the study, analytic biomechanical model and NIOSH guidelines are applied to evaluate risk levels of low back injury for automobile assembly jobs. Total of 246 workers are analysed. There are 20 jobs having greater back compressive forces than 300kg at L5/S1. Also, there are 44 jobs over Action Limit with respect to 1981 NIOSH guidelines. The relationship between psychosocial factors and low back injury was examined in the second part of the study. A battery of questionnaires concerning the psychosocial stress based on PWI (Psychosocial Well-being Index) and musculoskeletal pain symptoms at low back was completed by 246 workers at the same plant. Results showed that 207 out 246 workers experienced the symptoms and 27 workers were diagnosed as patients. Two groups(low stressed, high stressed) based on PWI score had no significant relationships with both symptoms and results of diagnosis. The relationships between physical work load and psychosocial stress were also analysed. Specifically, some postural factors(vertical deviation angle of forearm, horizontal deviation angle of upperarm, vertical deviation angle of thigh, etc) were highly correlated with psychosocial stress. The results illustrated that PWI scores were associated with some physical workloads. However, psychosocial stress levels couldn't be well related with the pain symptom as well as the actual incidence of low back injury since pain or discomfort regarding low back injury were more complex than that of other musculoskeletal disorders.

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A Model for Health Promoting Behaviors in Late-middle Aged Woman (중년후기 여성의 건강증진행위 모형구축)

  • Park, Chai-Soon
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.298-331
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    • 1996
  • Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

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MMPI and SCL-90-R Profiles in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자의 MMPI 및 SCL-90-R 반응 특성)

  • Kim, Kyoung-Woo;Yoon, Seok-Joon;Yang, Chang-Kook;Han, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.37-47
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    • 2002
  • Objective : Previous studies have suggested an association between sleep-related breathing disorder (SRBD) and several psychological problems, and there were increasing recognition of the link. The purpose of this study is to evaluate the characteristic profiles of MMPI and SCL-90-R in patients with SRBD. Methods : This study consisted of 80 SRBD patients(73 men, 7 women) referred from Sleep Disorder Clinic of Dong-A University Hospital, Busan, Korea. Basic informations including demographic findings and physical examination were collected. Subjects completed the Epworth Sleepiness Scale(ESS), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revision (SCL-90-R) prior to standard overnight polysomnography that was performed at hospital sleep laboratory. SRBD was divided into two groups of primary snoring(PS) and obstructive sleep apnea(OSA) according to polysomnographic findings. Results : SRBD showed significant elevation rate of Hs, D, and Hy scales of MMPI and SOM scale of SCL-90-R, which exceeded the rate expected in normal individuals(>5%, 2SD). On comparison of clinical scales of SCL-90-R, OSA group had significantly greater mean score than that of PS group in terms of O-C, DEP, PAR, GSI(p<0.05), SOM and PST(p<0.01). OSA group also showed significantly higher elevation rate in Hs scale of MMPI and SOM scale of SCL-90-R than that of PS. Among OSA group, three scales of MMPI(D, Pt, Si) and three scales of SCL-90-R(ANX, PAR, PSDI) had significant correlation with some PSG variables including total sleep time and sleep efficiency. Among PS group, two scales of MMPI(Hy and Pt), elevation rate of MMPI scales and three scales of SCL-90-R(I-S, PAR, PSDI) had significant correlation with some PSG variables including sleep efficiency, sleep latency and REM sleep percent. Conclusion : The above results suggest that SRBD show neurotic profiles in MMPI and SCL-90-R. This study also clearly indicates that PS group are suffered from clinically meaningful psychiatric symptoms, which are quantitatively lessened but qualitatively similar as compared to that of OSA group.

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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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