• The Korean Journal of Pain
• /
• v.32 no.3
• /
• pp.196-205
• /
• 2019

Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

• Journal of agricultural medicine and community health
• /
• v.46 no.4
• /
• pp.207-217
• /
• 2021

Objectives: The purpose of this study was to investigate the factors in which employee's health beliefs affect their intention to get COVID-19 vaccines. Methods: The participants of this survey were 237 emlpoyees living in Busan. Data were collected using structured online questionnaires from April 26th to May 6th, 2021. The data were analyzed in SPSS WIN version 25.0 using descriptive statistics, t-test, chi-square test, multiple logistic regression analysis. Results: At the average score for each area of health beliefs regarding COVID-19, self-efficacy was 4.45 points, perceived sensitivity 4.71 points, perceived severity 3.59 points, perceived benefit 4.46 points, and perceived disability 2.19 points. Monthly income, perceived sensitivity, perceived severity, and perceived benefit were found to be factors affecting the intention to get COVID-19 vaccines. Conclusions: In order to improve the vaccination intention of COVID-19, it is necessary for subjects to recognize the seriousness of the disease, increase their sensitivity to the disease, and actively promote and educate the community about the benefits of vaccination.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.2
• /
• pp.204-214
• /
• 1999

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

• Journal of Korean Academy of Nursing
• /
• v.36 no.2
• /
• pp.373-380
• /
• 2006

Purpose: The purpose of this study was to identify the factors related to the wellbeing of the family caregivers of the elderly with a stroke. Methods: The subjects of this study were 199 elderly treated in four oriental hospitals in Korea, and their primary family caregivers. The data was collected by interviewsand a self reported Questionnaire, during the period from October, 2003 to April, 2004. Results: The results of this study were as follows. The mean score of wellbeing of family caregivers was 60.6412.63. The factors related to wellbeing of family caregivers were sex, age, education, depression, illness severity, ADL, paralysis, and speech disability in elderly characteristics. Among family caregivers characteristics, education, relation, and burden were significantly related. In situational variables, family income and the previous relationship between the elderly and family caregivers were related to wellbeing. Stepwise multiple regression analysis revealed that the most powerful predictor of wellbeing was the burden of family caregivers. A combination of the depression of elderly and age of family caregivers accounted for 50.3% of the variance of wellbeing. Conclusions: On developing the nursing intervention for improving wellbeing of family caregivers, many factors should be considered, especially caregiver burden, and elderly depression.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.39 no.5
• /
• pp.231-237
• /
• 2013

Objectives: This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. Materials and Methods: Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. Results: The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. Conclusion: Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction.

• The Korean Journal of Health Service Management
• /
• v.14 no.1
• /
• pp.147-159
• /
• 2020

Objectives: This study is the human factors and disease factors of the copayment system for the elderly (>65 years old) and to identify does the current status and characteristics of the applied elderly and conducted to provide basic data. Methods: Sample cohort data from the National Health Insurance Corporation database, from the years 2012-2015, were analyzed of 21,772 elderly people over the copayment ceiling. Results: The ratio of those who exceeded the copayment ceiling system rose sharply from progressive rates of 3.39% in 2012, 3.69% in 2013 and 5.03% in 2014, to rates of 37.13% from 2013. Factors identified that affect the instances of being over the copayment ceiling were: age, income group, region, severity, disability, sickness distribution, inpatient days, and outpatient days. Conclusions: The reorganization of the copayment ceiling system in 2014 favored low-income families of the elderly, but in 2015, the proportion of elderly was low (only 5.78%). The government's policies needs to change to allow for the amount of the deductible upper limit for low- and middle- income groups to be further subdivided in order for the elderly to receive more deductibles.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.3
• /
• pp.183-191
• /
• 2012

In most persons with disabilities had poor oral hygiene because of less attention and ability to perform a dental care. So the increased prevalence and severity of dental disease were common oral state. Although most persons with disabilities need a adequate dental treatment, it is often very difficult to treat because of noncooperativity and involuntary muscle movements. Dental treatments under sedation and general anesthesia were make to provide a high-quality dental service because of decreased anxiety and fear associated dental treatment in persons with disabilities. The dental professionals must be able to select and apply the proper sedation methods in agreement with the characteristics of the disabilities, general conditions, sedation experience and capacity of dentist, type and time of dental treatment, equipments of dental clinic, consent of patient's protector. The proshodontic treatment procedures, such as abutment preparation, dental impression taking process, try-in process of prosthesis and adjustment of occlusion, are difficult even for patients without disabilities. Those procedures are more difficult to patients with disability because it's too hard to control breathing and muscle. In this report, we performed prosthetic dentistry procedures to three patients with disabilities under dental sedation and general anesthesia.

• Journal of muscle and joint health
• /
• v.21 no.1
• /
• pp.65-74
• /
• 2014

Purpose: This study examined gender differences on Musculoskeletal disease (MSD) medical status, the characteristics of the approved patients in workers, and the factors affected approval. Methods: Claim data for the MSD to the Korea Worker's Compensation & Welfare Services (2011) were employed. The medical status by gender was analyzed using t-test, chi square-test and multivariate logistic regression models. Results: The number of claims for MSD has continuously increased in females but not in males since 2006. The severity measured by the care duration, surgery experience and disability grade has been substantially higher in males than in females. Age, size of company, types of occupation, work duration and the weight of materials handled daily were associated with the approval. When males were considered, the work duration, the weight of materials handled daily and parts of the body were statistically significant predictors of approval in males. In case of female, there were meaningful predictors in types of industry and parts of the body. Conclusion: These findings suggest that gender-specific risk factors of MSD should be measured and the management program for MSD should be developed.

• Journal of Korean Academy of Nursing Administration
• /
• v.15 no.1
• /
• pp.136-146
• /
• 2009

Purpose: The purpose of this study was to investigate the effects of copayments for doctor visits and prescription drugs on health services utilization in the Type I Medicaid beneficiaries in Korea. Method: This study examined data from the 2007 survey on Health Services Use and Health Status of Medicaid Beneficiaries performed by the Ministry for Health Welfare and Family Affairs. To analyze these sample survey data, the SURVEYFREQ, SURVEYMEANS, and SURVEYREG procedures which incorporate the sample design into the analyses were used. Results: Findings of this study indicate that copayments for doctor visits and prescription drugs of Medicaid Type I beneficiaries have cut overall medical costs. However, although results should be interpreted very carefully because of the relatively low $R^2$, copayments have cut more health services utilization of people who need more health services because of their complex diseases and disability. In addition, besides copayment, several factors are affecting differences in health services utilization before and after copayments implementation. Conclusion: These results highlight the need to examine the effects of copayments more thoroughly according to the kinds of disease, the severity of disease, and the level of copayment.

• The Korean Journal of Rehabilitation Nursing
• /
• v.12 no.1
• /
• pp.39-46
• /
• 2009

Purpose: The purpose of this study was to identify the level of burden and social support of mothers with Cerebral Palsy (CP) children, and to determine whether providing social support is an effective strategy to relieve the burden of those mothers. Method: From October to November 2007, the data were collected from 63 mothers with CP children who were admitted and treated for CP at Y rehabilitation center in Seoul. The data were analyzed with t-test, ANOVA, Scheffe's test, Pearson's Correlation Coefficient, and Stepwise Multiple Regression using SPSS 12.0. Results: Burden of mothers was related to the Gross Motor Function Classification System (GMFCS) of the CP children. Social support was negatively correlated and GMFCS was positively correlated with burden of mothers. Social support and GMFCS was statistically significantly related with burden of mothers with CP children by multiple regression analysis. Conclusion: There was a significantly negative correlation between social support and burden. It demonstrated that social support, an important factor relating to burden imposed on mothers of CP children, can be considered as an intervening variable which can contribute to decrease of burden. In addition, applying developmental screening measures are needed to decrease disability severity.