• Title/Summary/Keyword: Sleep: sleep disturbance

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A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

A Clinical Trial to Assess the Efficacy of Acupuncture on Hot Flashes in Postmenopausal Women;Focusing on the comparison of the effects of Traditional Korean medical acupuncture (TKMA) and Minimal Acupuncture (MA)

  • Kim, Dong-Il;Roh, Jin-Ju;Choi, Min-Sun;Lee, Seung-Deok;Roh, Ju-Won;Yoon, Sang-Ho;Ahn, Hong-Yup;Oh, Dal-Seok;Choi, Sun-Mi
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.74-85
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    • 2007
  • Objective : In this study we wanted to confirm if proper stimulation and de-Qi of traditional Korean medical acupuncture could increase hot flash relief efficacy. Design : A randomized controlled, single blind study. We used two modalities of acupuncture, one with optimal stimulation [Study group; Korean medical acupuncture (TKMA)] and one with minimal stimulation [Control group; Minimal acupuncture (MA)]. Same acupoints [PC6(內關), HT8(少府), HT7(神門), LI4(合谷), ST36(足三里), SP6(三陰交), Ren4(關元)] were used in both groups. Fifty-two patients were treated twice a week for 8 weeks, and follow up was done after 4 weeks from the last treatment. Patients were checked hot flash VAS (visual analog scale), frequency and duration every time they visited. Results : Hot flash relief efficacy by 100mm hot flash VAS was obvious in both groups. Hot flash VAS scores of study group were smaller than the scores of control group at the early stage (3rd, $4^{th}$ and $8^{th}$ visit), but there wasn't a remarkable difference between study and control group at the end of the trial. Besides, diminution of hot flash VAS was faster and more even in the study group than control group by visualization using 'Box plot'. We compared frequency and duration of hot flash, 100mm sweating, palpitation, sleep disturbance VAS, and Kupperman Index, MENQOL, Patient's global assessment score. Both groups showed definite decrease from the baseline, but the difference was not statistically significant. There wasn't any adverse event. Hot flash relief efficacy was kept in most patients after 4 weeks' follow-up. Conclusion : Acupoint combination by Traditional Korean medical theory is effective on hot flashes and hot flash relief efficacy was faster and more even in optimal stimulation than minimal stimulation.

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Characteristics of Psychiatric Consultation between Presenile and Senile Inpatients (초로기와 노년기 입원환자에 대한 정신건강의학과 자문의 특성)

  • Lee, Ji Woong;Cheon, Jin Sook;Kim, Kang Ryul;Kim, Hyun Seuk;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.114-121
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    • 2013
  • Objectives: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. Methods: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. Results: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. Conclusions : Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.

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Awareness and Consumption of Energy Drinks and Associated Factors among College Students in Cheongju (청주지역 대학생의 에너지 음료에 대한 인식과 섭취 실태 및 섭취 관련 요인)

  • Kim, Tae Yang;Kim, Soo Min;Kim, Ji Yeon;Im, Jeong Yeon;Yu, Hui;Han, Young-Hee;Hyun, Taisun
    • Korean Journal of Community Nutrition
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    • v.23 no.1
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    • pp.60-72
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    • 2018
  • Objectives: This study was conducted to investigate the awareness of energy drinks, energy drink consumption behaviors, and associated factors among college students. Methods: A total of 536 students from three universities in Cheongju completed a self-administered questionnaire regarding awareness and consumption of energy drinks as well as general characteristics, health-related characteristics, and eating habits. Results: Approximately half of the respondents reported they knew what energy drinks were, while 45.7% had heard of energy drinks but did not know what they were. However, 76.9% had experience in using energy drinks. The main reason for using energy drinks was to stay awake, and the main place that they were used was on campus or at the library. More than 70% of energy drink users did not read the caffeine contents of energy drinks. After consuming energy drinks, 31.3% experienced adverse effects, the most serious being sleep disturbance. Approximately 33% of students consumed energy drinks once a month or more frequently, and men consumed energy drinks more frequently than females. Energy drink users who consumed at least one drink each month were more likely to be natural science major or drink more milk for male students, and to have more allowances or consume less meat for female students, compared with non-users. Conclusions: Our study showed that 33% of students consumed at least one energy drink each month, and there were a small number of students consumed energy drinks almost every day or energy drinks mixed with alcohol. Accordingly, college students should be taught potential health hazards of energy drinks mixed with alcohol as well as energy drinks alone. In addition, reading labels about caffeine and sugar contents in energy drinks is encouraged.

Home-Based Hospice Care Provided by a Free-Standing Hospice Center: Patients' Characteristics and Service Conditions (일개 독립형 호스피스 기관의 가정호스피스 이용자 특성 및 서비스 제공 실태)

  • Kim, Hyoung Suk;June, Kyung Ja;Son, Young Sun
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.145-153
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    • 2016
  • Purpose: This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center. Methods: A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014. Results: Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (${\pm}3.98$), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (${\pm}3.12$). The frequency of doctor's home visits was $1.21{\pm}0.79$ on average, and the figure increased when patients' conditions turned unstable. Conclusion: It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.

A ground theory approach on fatigue of the female elderly with osteoarthritis (관절염을 앓고 있는 노인 여성 피로 경험의 근거 이론적 접근)

  • Kwon, Young-Eun;Chung, Myung-Sill
    • Journal of muscle and joint health
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    • v.3 no.1
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    • pp.50-62
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    • 1996
  • The purpose of this study was to identify and construct a substantive theory about the experience of fatigue among the female elderly with osteoarthritis. The interviewees were 6 female elderly with osteoarthritis. Of them 3 were admitted General hospital, the remaining 3 didn't admitted hospital. The data were collected through in-depth interviews by the investigators from May 20th, 1995 to June 19th, 1995. The collected data were coded into concepts and categories according to Strauss & Corbin's grounded method. The data thus collected were analyzed immediatly after interviews and fed into next round of interviews until the data collection reaches the saturation point where no additional concepts emerge. The 35 concepts were from analyzing the grounded data. The results of this study were as follows : 'change of the health condition','change of the life pattern', 'physiologic change', 'change of the coping pattern', 'performance of homework', 'activity daily living', 'tireness', 'ache', 'change of general apperance', 'sleep disturbance', 'powerlessness'. 'Physiologic unbalance', 'change of the family dynamics', 'physical imbalance', 'loss of the control', aviodance', 'conversion', 'leaving', 'indifference', 'hesitation', 'the pursue of information and trial', 'the western therapy', 'heat therapy', 'the oriental therapy','exercise', 'weight control', 'support', 'solution', 'being as before', 'adding more'. Six categories emerged from the analysis of ground data. They were as follows : 'stimuli', 'fatigue', 'passive coping', 'active coping', 'disolution', 'remains'. 13 hypothesis were derived from the integration of categories as follows : 1. The stronger the stimulus as perceived by the subjects, the more the fatigue will exrerience. 2. The more severe the fatigue, the more severe the tireness. 3. The more severe the fatigue, the more the hardness. 4. The more severe the fatigue, the more the variability of appear will experience. 5. The more severe the fatigue, the more the pain will experience. 6. The more severe the fatigue, the more the insomnia will experience. 7. The more severe the fatigue, the more the powerless will experience. 8 The more severe the fatigue, the more the psychological unbalance will experience. 9. The more severe the fatigue, the more variability of the family dynamics will experience. 10. The more severe the fatigue, the more the physical unbalance will experience. 11. The more severe the fatigue, the more loss of control will experience. 12. The subjects who experienced the fatigue will be to show passive coping and active coping mechanism.

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Quality of Life and Economic Impact of Adult Atopic Dermatitis Patients in Seoul (서울 지역을 대상으로 모집된 성인 아토피피부염 환자의 삶의 질과 경제적 비용 부담에 관한 조사)

  • Yun, Young-Hee;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.1
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    • pp.199-214
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    • 2010
  • Objective : Atopic dermatitis (AD) may profoundly affect patient's quality of life (QOL), and also cause economic impact. The aim of our study was to evaluate the quality of life and the economic impact of adult atopic dermatitis patient in Seoul. We also evaluate the relationship of QOL and economic impact with severity of AD. Methods : 30 adult atopic dermatitis patient were included and evaluated by using the SCORAD Index and EASI. Patients were asked to fill in the questionnaires about their quality of life and financial costs during the past year by AD. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation were used for statistical analysis. Results : 1. Among 30 patients, women were 19(63.3%), men were 11(36.7%). The mean age of the patients were 27.3 years old, patients between the ages of 17 and 30 years were 23, over 30 were seven. 2. The mean score of Objective SCORAD was $32.89{\pm}7.30$, Subjective SCORAD was $8.13{\pm}3.53$ and EASI was $9.15{\pm}6.90$이었다. 3. The mean score of Skindex-29 was $28.26{\pm}7.58$, DLQI was $10.17{\pm}5.55$. 4. By analyzing the questionnaire, a monthly average cost of 583,200 won for each patient was determined. Direct cost was 236,800 won and indirect cost was 346,300 won. 5. By analyzing the correlation between the severity of AD and QOL, Objective SCORAD and EASI were positively correlated with QOL(Skindex-29, DLQI) but not significant, meanwhile subjective SCORAD were significantly and positively correlated with QOL(Skindex-29, DLQI). 6. By analyzing the correlation between the severity of AD and economic impact, Objective SCORAD were significantly and positively correlated with direct cost and indirect cost. Also, EASI were significantly and positively correlated with direct cost and oriental medical hospital visits. Conclusions : The above results show that the QOL of the patients with atopic dermatitis is significantly related to their disease severity. Atopic dermatitis patients pay 583,200 won a month, and the economic impact of the patients is significantly related to their disease severity.

A Structural Equation Model on Quality of Life in Hemodialysis Patients (혈액투석환자의 삶의 질 구조모형)

  • Kang, Seung-Ja;Seo, Nam-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.589-598
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    • 2019
  • This study was conducted to build a structural equation model explaining factors that affect hemodialysis patients' quality of life to test the goodness of fit of the model and identify directly and indirectly significant paths. To accomplish this, 230 patients receiving hemodialysis registered at study hospitals in G Metropolitan City and M City were randomly selected, and 201 were used in the final analysis. Data were collected using a self reporting questionnaire from February 1 to March 31, 2014. SPSS WIN 18.0 was used for descriptive statistics and correlation analysis of the general characteristics and for reliability analysis of the research tools. In addition, AMOS 18.0 was used for confirmatory factor analysis of latent variables, to determine the goodness of fit of the hypothetic model, and hypotheses testing. The results of this study were as follows: the fit of the modified model was 41.32, GFI = .96, AGFI = .92, RMR = .04, NFI = .96, CFI = .91 and TLI = .95. Twelve out of the 22 research hypotheses that were improved and improved were statistically significant. The results indicated that hemodialysis patients' quality of life was influenced directly by self-efficacy, depression, and self-care behavior, and indirectly by sleep disturbance, stress, fatigue, and family support. These variables explained 58.6% of the variation in quality of life. Overall, these findings suggest that nursing interventions for hemodialysis patients require strategies for managing patient depression and for increasing self-efficacy and self-care behavior to improve quality of life.

Effect of Aromatherapy on Behavioral and Psychological Symptoms of Dementia (아로마요법이 치매행동심리증상에 미치는 효과)

  • Choi, Seung Wan
    • 한국노년학
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    • v.28 no.4
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    • pp.1069-1087
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    • 2008
  • The purpose of this study was to closely examine the effects of aromatherapy on Behavioral and Psychological Symptoms of Dementia(BPSD) to the elderly in a nursing home, and to help the application of aromatherapy is expected to be conducive to managing the quality life in the dementia and the care-giver, and to provide a base of the aromatherapy application as an elderly program in geriatric institutions. This is an one group pre-post test design and the research subjects were the dementia in a nursing home those were totally 15 available for communication or intention observation. Aromatherapy was offered for 3 weeks totally 15 times by once a day in each with aroma hand massage and inhalation, by blending essential oils, Lavender, Chamomile Roman and Grapefruit. The results are as follows. Given examining a change in the whole about whether there are effects of aromatherapy on BPSD, there was significant difference in a change depending on the experimental period with 1.47 for the pre-measurement value, 1.09 for the post 1-measurement value, 1.01 for the post 2-measurement value and 0.71 for the post 3-measurement value. And, even the difference in experimental period was indicated to have significant difference(F=11.501, p<0.001). As an itemized results, the effect of aromatherapy were indicated to have significant difference on easing the anxiety, anguish, fear, dreadful feeling, depressed feeling, and outstandingly bustling movement, and outstandingly inactive behavior, and sleep disturbance and behavior of wandering about at night. On the basis of the result in this study, the application of aromatherapy is expected to lead the quality life in the dementia, and to contribute to health of mind and body in the dementia as an program in geriatric institutions.

A Case Report of Persistent Postural-Perceptual Dizziness Treated with Korean Medicine (한방 치료로 호전된 지속체위 - 지각어지럼에 대한 증례 1례)

  • Kim, Min-hwa;Heo, Gi-yoon;Kang, Hee-kyung;Nam, I-rang;Kim, Maria;Lee, In;Kwon, Jung-nam;Kim, So-yeon;Yun, Young-ju;Choi, Jun-yong;Han, Chang-woo;Park, So-jung;Hong, Jin-woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.769-778
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    • 2022
  • Objectives: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of persistent postural-perceptual dizziness. Methods: A patient with dizziness was treated with Banhabackchulchunma-tang and Gongjin-dan herbal medicines. The severity of symptoms was assessed with a daily visual analog scale (VAS) for dizziness and the frequency of subjective trembling feelings (over 30 minutes). Results: After the treatment, the severity of dizziness was reduced from VAS 5 to VAS 2, and fatigue was improved from VAS 5 to VAS 1. The frequency of subjective trembling feelings was reduced from once every 3-4 days to once every 10 days. Other symptoms, such as dyspepsia, sleep disturbance, and hot flashes, also showed improvement. Conclusion: Treatment with Korean medicine may be an effective option for the treatment of persistent postural-perceptual dizziness.