• 대한정형도수물리치료학회지
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• 제28권3호
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• pp.21-32
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• 2022

Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.

• 정신신체의학
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• 제20권2호
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• pp.120-126
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• 2012

연구목적 : 흉통을 호소하여 방문한 환자를 대상으로 우울, 불안, 자존감, 그리고 삶의 질 을 조사하고, 전형적 흉통과 비전형적 흉통에 따른 차이를 비교하였다. 방 법 : 39명의 흉통 환자와 40명의 대조군을 대상으로 하였으며, 순환기 내과 전문의의 문진과 심장 전산화 단층촬영, 답차운동부하검사, 관상동맥조영술 등을 시행하여 전형적 흉통과 비전형적 흉통을 감별하였다. 우울, 불안, 자존감, 그리고 삶의 질을 평가하기 위해 BDI(Beck's Depression scale), STAI(State trait anxiety inven-tory), RSES(Rosenberg Self-esteem Scale), SBQOL(SmithKlein Beecham Quality of Life Scale)를 적용하였다. 결 과 : 심질환의 위험인자는 가족력을 제외하고는 전형적 흉통군, 비전형적 흉통군, 그리고 대조군 간에 차이가 없었다. 우울은 대조군에 비해 두 가지 흉통군 모두에 더 높았으나 흉통군 간에는 차이가 없었다. 불안은 대조군에 비해 두 가지 흉통군 모두에서 더 높았고, 전형적 흉통군에 비해 비전형적 흉통군에서 더 높았다. 자존감과 삶의 질은 대조군과 전형적 흉통군에 비해 비전형적 흉통군에서 더 낮았다. 결 론 : 흉통환자에서 불안과 우울에 대한 평가와 개입이 필요하며, 특히 비전형적 흉통환자에서는 자존감과 삶의 질 저하에 대한 접근도 병행이 되어야 함을 시사한다.

• 종양간호연구
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• 제5권1호
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• pp.11-21
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• 2005

The purpose of this study were to develop an web-based education program for Lung cancer patients and to test its effects on patients' self-care knowledge, compliance to medical regimen, nutrition status and pain. The program was developed by the following process: first, Lung cancer patients demand on the web-based program was investigated. and second, the program was developed with the help of various reference books and then validation of experts group. last, educations effects on the patients is evaluated and compared the differences in self-care knowledge, compliance to medical regimen, nutrition status and pain between on experimental group and a control group on before discharge 1day and 3weeks after. SPSS/Win 11.0 program was used for data analysis. It was proven with $x^2$ test and t-test, and Pearson Correlation coefficient, and Chronbach's alpha coefficient were done for the reliability of measuring instruments. 1. The summary of the Program development is as follows. The program is based on patients' questionnaire and reference material and is made for users friendly. Not only Bigger font size and bright colors but also illustrations or pictures were adopted to help enhance patients' understanding. 2. The summary of the study results is as follows. 1) Compared with control group, the web-based educated experimental group showed a statistical significant difference on self-care knowledge, Especially disease, radiation treatment, medication & analgesics, chemotherapy side effect, but there was no significant difference in the field of chemotherapy, in the fields of operation, diet & general knowledge. 2) Compared with control group, the web-based educated experimental group showed a statistical significant difference on compliance to medical regimen, especially in the field of follow up care, everyday life, diet, but there was no significant difference in the field of medication, exercise. 3) Compared with control group, web-based educated experimental group showed no significant difference in nutrition status, but partially significant difference in body weight. 4) Compared with control group, the web-based educated experimental group showed no significant difference in pain level. 5) The significantly positive correalation self-care knowledge with the compliance to medical regimen. 6) Users satisfaction with the web-based education program of the contents quality, the level of recommendation to others, content layout, medical information quality, but interesting got a low mark.

• Journal of Acupuncture Research
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• 제24권6호
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• pp.89-96
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• 2007

Objectives : To observe the effect of acupuncture treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E Group, n=18) and a control group(C Group, n=18). The E Group patients received acupuncture treatment on $LI_{15}$, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results : The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(p>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C Group, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

• Korean Journal of Acupuncture
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• 제28권4호
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• pp.1-15
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• 2011

Objectives : The purpose of this study is to evaluate the feasibility of massive clinical research and to make a basic analysis on the effectiveness and safety of moxibustion treatment on knee osteoarthritis compared to usual care. Methods and Results : This study is a protocol for a pilot randomized controlled trial. Forty participants are assigned to the moxibustion group (n=20) and usual care group (n=20). Participants assigned to the moxibustion group receive moxibustion treatment on the affected knee(s) at six standard acupuncture points (ST36, ST35, ST34, SP9, Ex-LE04 and SP10) three times per week for four weeks (total of 12 sessions). Participants in the usual care group don't receive moxibustion treatment during the study period and follow-up are made on the 5th, 9th and 13th weeks after random allocation. Both groups are allowed to use any kind of treatment, including surgery, conventional medication, physical treatment, acupuncture, herbal medicine, over-the-counter drugs and other active treatments. Education material that explains knee osteoarthritis and current management options and self-exercise is provided for each group. The pain scale of the Korean Western Ontario and McMaster Universities Questionnaire (K-WOMAC) is the primary outcome measurement used in this study. Other subscales of the K-WOMAC, the Short-Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI), Physical Function test, Patient Global Assessment, and Pain Numeric Rating Scale (NRS) are used as outcome variables to evaluate the effectiveness of acupuncture. Safety is assessed at every visit. Conclusions : The result of this trial will provide a basis for the effectiveness and safety of acupuncture treatment for knee osteoarthritis.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.441-447
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• 2007

악관절 내장증은 관절과두와 관절원판이 이루는 복합체의 기능적 관계가 파괴되어 관절원판이 변위되는 것이다. 관절원판의 변위는 전내방으로의 변위가 가장 흔하며, 정복성 관절원판 변위와 비정복성 관절원판 변위로 나뉘어진다. 악관절 내장증환자의 치료로는 교합안정장치, 물리치료, 운동요법, 행동요법 등의 보존적 치료법을 우선 고려하여야 하고, 충분한 기간 동안의 보존적 치료에도 증상의 변화가 적은 경우에 외과적 처치를 고려해 볼 수 있다. 악관절 수조작술은 앞서 언급한 보존적 치료법들과 함께 시행하는 보존적 술식으로 전방으로 변위된 관절 원판의 정복을 도모하고, 원판후조직의 적응을 유도하기 위해 시행한다. 전통적으로 Farrar의 방법을 널리 이용해왔으며, 이에 대한 많은 성공적 임상 사례들이 보고된 바 있고, 그 밖에도 몇몇 수조작법들이 소개된 바 있다. 그러나 전통적인 방법은 술자에 의해 이루어지는 것으로 환자가 병원에 내원할 경우에만 시행할 수 있어 수조작법의 치료 효과를 높이기 위해 환자가 스스로 시행할 수 있는 방법의 필요성이 제시되었다. Minagi, Mongini, Suarez 등은 환자 스스로 시행할 수 있는 수조작법을 소개한 바 있으나, 전통적인 수조작법과 비교한 자가 수조작법의 효과에 대한 연구는 현재까지 보고된 바가 없다. 본 연구에서는 Minagi, Mongini, Suarez 등에 의해 소개된 환자 스스로 시행할 수 있는 수조작법을 보완하여, 임상적으로 활용이 가능한 자가 수조작법을 소개하고 내원한 환자에 대하여 치과의사가 직접 실시하는 전통적인 수조작법과 환자의 교육을 통해 환자 자신이 일상에서 시행하도록 한 자가 수조작법이 악관절 자기공명영상검사로 확진된 비정복성 관절원판 전방변위로 인한 개구제한 환자들의 치료 성과에 어떠한 영향을 미치는지 알아보고자 하였다. 연구를 위해 구강내과에 2002년 12월부터 2004년 11월까지 측두하악관절장애로 진단 받은 환자 중 개구제한이 관찰되고 악관절 자기공명영상 검사에서 비정복성 관절원판 전방변위가 확진된 뒤 물리치료, 운동요법, 행동요법, 교합안정장치 및 수조작법을 시행하여 치료가 종결된 환자들을 대상으로 하였다. 초진시 환자는 개구제한과 함께 통증 등의 다양한 증상을 함께 호소하였고, 이에 따라 치료의 종결은 개구량의 증가와 더불어 환자의 주관적 불편감이 더 이상 존재하지 않아 내원을 중단할 수 있을 때로 결정하였다. 환자들의 의무 기록을 토대로 치료기간, 개구량의 증가, 주관적 증상의 개선 정도를 수조작법의 종류에 따라 후향 조사하였다. 전통적인 수조작법을 시행한 군과 변형된 자가 수조작법을 시행한 군의 차이를 분석하기 위하여 chi-squared test, Mann-Whitney U-test를 시행하였다. 치료 결과 개구량이 40 mm 이상으로 증가한 환자의 분포는 전통적인 수조작법을 시행한 군(42.9%)보다 자가 수조작법을 시행한 군(69.9%)에서 더 높은 경향을 보였으나, 그 차이가 통계적으로 유의하지는 않았다. 치료기간에 있어서는 치료의 종결 시점을 40 mm이상의 개구량이 확보되고 환자가 초진시 호소한 주관적 불편감이 해소된 때로 하였고, 이에 따라 치료가 종결된 환자의 치료기간은 전통적인 수조작법을 시행한 군($61.0{\pm}38.0$ 주)보다 자가 수조작법을 시행한 군($29.2{\pm}12.3$ 주)에서 통계적으로 유의한 수준으로 짧았다. (p<0.01) 결론적으로, 비정복성 관절원판 전방변위로 인한 개구장애 환자의 치료에 있어서 자가 수조작법의 시행은 환자가 수조작법을 교육받고 정해진 바에 따라 매일 시행하는 치료과정을 통해 개구량을 증가시킬 수 있고, 전통적인 수조작법에 비하여 전체적인 치료 기간을 단축시킬 수 있는 효과적인 치료법이라고 할 수 있다.

• 근관절건강학회지
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• 제3권2호
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• pp.135-150
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• 1996

This study was performed to analyze the patient's experience during the progress of disease in the patients with osteoarthritis, who are taken the replacement surgery of knee Joint. The examine was consisted of five patients with osteoarthritis, who are taken the replacement surgery of knee joint from Dec. 4. 1995 to May, 20, 1996 at C university hospital. After hospitalization, the physical and psycho-logical status of the patients during preoperation, postoperation and discharge was examined. The data were examined according to the ethnographic method. The results are as follows. The patients experienced the periods of embarrasment, conflict, before surgery suffering, acceptance period after surgery. In the embarrasment period, the patients take a multiple medication therapy including hospital treatment, oriental medication and folk medication to ameliorate joint pain after first diagnosis on arthritis. The embarrasment period includes compulsive drug medication, oriental medication, folk medication, trouble some, sadness and survey of hospitals. In the conflict period, the patients consider the operation of knee because of working difficulty and severe Joint Pain, while they feel anxiety about the surgery. They condemn their physical situations. They have the conflict and anxiety on surgical operation. they consider the quality of life. They hope the surgery makes patients to improve walking ability. This period includes self-condemned, sorry, tiresomeness, expectation, worrisomeness, anxiety and hesitance. In the suffering period, the patients experience post operation physical discomfort after the total knee replacement. They do physical exercise, including extension and straight leg raising to maintain walking ability, while they endure to wait approximately 6 months for normal walking movements and they are also unstable to environmental people's sight. This period includes postoperative pain, continuous discomfort, inability and communication difficulty to other's people. In the acceptance period, the patients consider longerity of artificial Joint and also endure mild remaining joint pain. Some of them have religions for their wellbeing of life. This period include a self-protesting policy, abandonment, self-consolation, dependence on religions. According to the result from this study I suggested these shown below. 1) After replacement surgery of knee joint, continuous investigation on outcome patient is necessary. 2) It is also necessary to analyze on patient's experiences, who are taken the replacement surgery of hip Joint. 3) Study on disease experiences of patients with rhematoid arthritis, who take drug medication and physical therapy alone without surgery, is necessary. 4) Investigation on patient's favorable folk medication may be helpful to analyze disease experience of patients with osteoarthritis.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.245-251
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• 2023

Background: The incidence of facial palsy has been increasing. Many patients consult both Korean and Western physicians; however, no critical pathway (CP) for facial palsy has been established based on integrated medicine including Korean medicine, Western medicine, and complementary and alternative medicine. Thus, we developed and implemented an integrated CP for patients with acute facial palsy and investigated the satisfaction with CP. Methods: Overall, 20 patients who received treatment following the CP and 20 medical staff members involved in their care responded to a questionnaire survey. The questionnaire was developed based on a review of previous studies and focused on the satisfaction with the CP. Results: Patients' satisfaction score with the integrated CP was ≥ 4.4 for all items using a 5-point Likert-type scale. Smooth and cooperative treatment procedures, time-saving practices, and a clear explanation of the integrated treatment plan were satisfactory factors. Additionally, they preferred incorporating specialized facial massage and receiving education on self-exercise or massage techniques as complementary therapies. The medical staff members expressed a high level of satisfaction with the CP; however, the work division and treatment guidelines must be improved. Conclusion: An integrated CP program for acute facial palsy was implemented, and the satisfaction levels of patients and medical staff members were assessed. The results revealed high levels of satisfaction, and several improvements identified will be incorporated into clinical practice going forward.

• 대한예방한의학회지
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• 제5권2호
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• pp.40-68
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• 2001

In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

• 가정∙방문간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.