• 대한간호학회지
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• 제47권2호
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• pp.143-163
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• 2017

Purpose: This study was a systematic review and meta-analysis designed to investigate effects of psychoeducational intervention for cancer survivors. Methods: Ten databases were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration's tool. To estimate the effect size, meta-analysis of the studies was performed using Comprehensive Meta-Analysis and RevMan programs. Results: Of 18,781 publications identified, 35 met inclusion criteria, and 25 studies were used to estimate effect size of psychoeducational intervention. Effect sizes (standardized mean difference [SMD]) were heterogeneous and random effects models were used in the analyses. Psychoeducational intervention was effective for quality of life (n=2,410, ES=0.23; 95% CI: 0.09~0.37), coping and self-efficacy (n=179, ES=0.68; 95% CI: 0.26~1.11), anxiety (n=1,786, ES=-0.26; 95% CI: -0.37~-0.15), depression (n=1,910, ES=-0.28; 95% CI: -0.37~-0.18), and psychological distress (n=2,242, ES=-0.31; 95% CI: -0.46~-0.17). Subgroup analysis showed that counseling was the most effective intervention for quality of life, and behavioral therapy was an effective intervention for all positive and negative outcomes. Publication bias was not detected except for psychological distress. Conclusion: Psychoeducational intervention appears to be effective in improving quality of life and coping and self-efficacy, and it is effective in reducing psychological symptoms in cancer survivors. Behavioral therapy, especially, is commonly effective in improving psychosocial outcomes. However, low-quality evidence, variability in the designs of existing studies, and publication bias suggest that additional high-quality trials should be conducted in the future.

• 한방재활의학과학회지
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• 제28권3호
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• pp.55-66
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• 2018

Objectives To evaluate the evidence supporting the effectiveness of bee venom acupuncture for ankle sprain. Methods We conducted search across 11 electronic databases (Pubmed, EMBASE, Cochrane CENTRAL [CENTRAL], KoreaMed, Kmbase, Koreanstudies Information Service System [KISS], National Digital Science Library [NDSL], Korea Institute of Science and Technology Information [KISTI], China National Knowledge Infrastructure [CNKI], Wanfang and Chinese Scientific Journals Database [VIP] database) to find clinical trials that used bee venom acupuncture as treatment for ankle sprain. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane Risk of Bias (RoB) tool, while non-randomized controlled clinical trials (NRCTs) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Four RCTs and one nRCT met our inclusion criteria. Almost studies showed that bee venom acupuncture has positive effect on ankle sprain. 4 studies of same intervention and control included in the meta-analysis. When comparing bee venom acupuncture and acupuncture with acupuncture, the effect size of standardized mean difference (SMD) was -0.19 (95% confidence interval [CI]: -1.95~1.56, Z=0.55, p=0.83). And when comparing bee venom acupuncture with acupuncture, the effect size of SMD was -0.17 (95% CI: -0.65~0.31, Z=0.71, p=0.48). Conclusions Although our systematic review found encouraging but limited evidence of bee venom acupuncture for ankle sprain, most of the studies included in the analysis were evaluated as methodologically high risk of bias. From now on further well-designed RCTs should be encouraged.

• 동의신경정신과학회지
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• 제19권3호
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• pp.45-54
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• 2008

Objective: To treat psychogenic headache patients, doctors have to amplify on the headache caused by emotional stress to patients, and assist the patients to cope with difficulties. So, we investigated HRV of the headache patients caused by Chiljungsang and would like to apply to the clinical treatment. Method: Our study measured time and frequency domain HRV indicies(5-min resting study) of 123 headache patients caused by emotional stress. Standardized tests of HRV allow a quantitative estimation of autonomic nervous system function. Results & Conclusions: 1. The study classed as aspects of the head pain showed the differences in RMS-SD(square root of mean squared difference of successive NN intervals) band, HF(high frequency) band significantly. 2. The male headache patients showed higher all the indicies except heart rate compared to the female patients, significantly in SDNN(standard deviation of NN interval), TP(total Power), HF band. 3. As the patients grow older, SDNN, RMS-SD band was lower and LF(low frequency) band, LF/HF ratio higher significantly. The beginning age lower, SDNN, RMS-SD band was higher significantly. The duration of the disease longer, LF band, LF/HF ratio was higher significantly.

• 한국콘텐츠학회논문지
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• 제17권2호
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• pp.125-136
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• 2017

본 연구는 중학생을 대상으로 집단따돌림 동조유형이 집단따돌림 가해행위에 미치는 영향에서 공감능력의 조절효과를 검증하기 위해 설계되었다. 연구 대상자는 부산지역에 거주하는 중학교 1, 2학년 488명이다. 분석을 위해 SPSS 20 프로그램을 사용하였고, 평균차이 검증과, 조절회귀분석을 실시하였으며, 조절효과의 특성을 보여주기 위해 관련변수를 표준화하여 제시하였다. 연구결과 첫째, 가해자 동조경험과 방관자 동조 경험이 많을수록 집단따돌림 가해행위는 더 높은 것으로 나타나 집단따돌림 가해행위를 예측하는 요인으로, 가해자동조와 방관자동조는 중요한 변수로 확인되었다. 둘째, 공감능력은 가해자동조와 집단따돌림 가해행위관계와, 방관자동조와 집단따돌림 가해행위의 관계를 완화시키는 조절효과를 가지는 것으로 나타났다. 셋째, 성별에 따른 분석에서는 남학생이 여학생보다 집단따돌림 가해행위에 더 많이 노출되고, 학년이 높을수록 방관자동조를 많이 하는 것으로 나타났다. 이러한 연구결과에 따른 논의를 통해 사회복지 실천적 제언과, 학문적 제언과 그리고 후속연구에 대한 제언이 이루어졌다.

• The Korean Journal of Pain
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• 제30권4호
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• pp.250-257
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• 2017

Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared ($I^2$) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was -0.56 (95% confidence interval: -1.05, -0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.

• 간호행정학회지
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• 제8권2호
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• pp.295-308
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• 2002

Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

• 한국임상약학회지
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• 제27권3호
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• pp.161-170
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• 2017

Background: There is recent evidence that insulin resistance is responsible for increasing the risk of developing cognitive dysfunction. To systematically review the influence of intranasal insulin treatment on the cognitive function in Alzheimer's disease patients. Methods: Randomized controlled trials comparing the cognitive effects of intranasal insulin therapy in Alzheimer's disease patients with controlled interventions were retrieved from Pubmed, Medline, Embase and Cochrane library. Meta-analysis was conducted on the cognitive measurements with a subgroup analysis by dose, gender and apolipoprotein E allele 4 (ApoE ${\varepsilon}4$) status. Results: Seven randomized controlled trials were eligible for inclusion. Intranasal insulin had a positive influence on the cognitive function as compared to placebo without a statistical significance (standardized mean difference; SMD = 0.109; 95% confidence interval; CI -0.04 to 0.26; P=0.14). In subgroup analysis, a 20 IU dose of intranasal insulin induced a significant improvement in cognitive function (SMD = 0.14; 95% CI 0.05 to 0.24; P=0.004), but 40 IU did not show this effect (SMD = -0.01; 95% CI -0.11 to 0.09; P=0.82). ApoE ${\varepsilon}4$ positive patients showed a significant decline in cognitive function as compared to ApoE ${\varepsilon}4$ positive patients in the control group (SMD = -0.213; 95% CI -0.38 to -0.04; P=0.015). Such an effect was not apparent in ApoE ${\varepsilon}4$ negative patients. Gender had no influence on the cognitive outcomes. Conclusion: The results indicate that intranasal insulin may have beneficial effect in improving the cognitive function in Alzheimer's disease patients.

• 한국융합학회논문지
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• 제9권6호
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• pp.347-355
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• 2018

본 연구는 우리나라 노인을 대상으로 시행된 웃음치료의 융합적 메타분석을 통해, 노인우울 감소 효과크기를 확인하고, 노인의 우울감소를 위한 웃음치료의 중재특성과 경향을 파악하기 위하여 실시된 융합적 연구이다. 10개의 데이터베이스 검색을 통해 확인한 486개 문헌 중 선정기준에 부합하는 20문헌을 최종 선정하였다. SIGN의 도구를 이용하여 문헌의 질평가를 시행하였으며 CMA 3.0을 활용하여 자료를 분석하였다. 노인우울에 대한 웃음치료의 전체효과크기는 중간크기로 나타났으며 (SMD=-0.57, 95% CI: -0.70~-0.44, p<.001), 작은 크기의 이질성을 보였다($I^2=18%$). 하위그룹 분석에서 재가노인, 통합군, 4-6주 중재군, 집단중재군의 효과가 더 컸다. 본 융합연구의 결과를 활용하여 효과적인 웃음치료 프로그램 구성을 도모할 수 있을 것이며, 추후 노인요양시설 노인을 대상으로 한 반복연구와 무작위배정 실험연구가 더 필요하다.

• 한방재활의학과학회지
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• 제27권3호
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• pp.47-60
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• 2017

Objectives The aim of this research is to assess the effects of bee venom acupuncture for knee osteoarthritis. Methods For a systematic review, we constructed a key question as the effect of bee venom acupuncture for knee osteoarthritis and selected RCTs and nRCTs. We searched the following 15 databases without a language restriction: Pubmed, EMBASE, Cochrane CENTRAL (CENTRAL), CINAHL, AMED, seven Korean medical databases (KoreaMed, Kmbase, KISS, NDSL, KISTI, Koreantk, OASIS) and three Chinese databases including CNKI, Wanfang and VIP database. Results A total of 300 potentially relevant studies were identified; only 13 studies were selected for systematic review. Almost studies showed that bee venom acupuncture has significant effect on knee osteoarthritis. 5 studies comparing bee venom acupuncture with acupuncture were included in the meta-analysis. The effect size of standardized mean difference (SMD) was analyzed as 'small effect' with 0.47 (95% CI: 0.10~0.83, Z=2.49, p=0.01). Conclusions The research showed that bee venom acupuncture can significantly reduce pain, stiffness and improve the quality of life of patients with knee osteoarthritis. However, most of the studies included in the analysis were evaluated as methodologically high risk of bias. This suggests that there is limitation applying this study. In the future, more Randomized Controlled trial should be actively conducted.

• 대한영양사협회학술지
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• 제22권1호
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.