• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.147-155
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• 2008

Purpose: This study aimed to assess the educational needs for nurses who care for terminal cancer patients and their families. To identify top needs along with key issues in consideration to develope hospice training program and provide specific recommendations. Methods: A cross-sectional design with nurses from nine universities' hospice specialist courses and seven cancer centers was used. Data were collected via e-mail or mail service from March to April in 2008. One hundred seventy three questionnaires were returned (return rate: 73.6%), and 156 questionnaires were eventually analyzed. The questionnaire consisted of Mason and Ellershaw's The Self-efficacy in Palliative Care (SEPC) and self-reporting confidence and educational needs in hospice care. Results: The mean age of the participants was 37.94 years, 82.1% were staff nurses, and 44.9% completed over six months hospice education. Mean$\pm$standard deviation score for total SEPC was $2.67{\pm}.62$, which was lower than average (score 3), with communication score being the lowest ($2.49{\pm}.69$). The lowest self-reporting confidence score was $2.03{\pm}.77$ in hospice administration and management, followed by providing complement therapy ($2.34{\pm}.77$), bereavement care ($2.34{\pm}.71$), lymph edema management ($2.35{\pm}.79$), and care planning ($2.36{\pm}.81$). The participants reported that additional education is needed in all topics, with pain management score being the highest ($3.71{\pm}.50$), followed by pain and symptom evaluation ($3.67{\pm}.52$), care for dying ($3.67{\pm}.52$), and communication and counseling ($3.63{\pm}.53$). There were significant subgroup differences in SEPC and self-reporting confidence between groups who completed 6 months hospice education or not, however, no significant difference in educational need between the groups. Conclusion: This study showed the need for developing hospice training program to improve compentency of nurses in hospice palliative care.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.141-145
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• 1999

Purpose : Granisetron is a potent, the most selective 5-HT3 receptor antagonist and is reported to b effective in treatment of radiation-induced emesis. The antiemetic efficacy and safety of oral granisteron was evaluated in patients with receiving highly emetogenic treatment by conventional fractionated irradiation. Materials and Methods : Patients with various cancers who were being treated with irradiation were accrued into the present study. The intensity of nausea was evaluated on first 24 hours and on day-7 by patients according to the degree of interference with normal daily life as followings; a) none; b) present but no interference with normal daily life (mild): c) interference with normal daily life (moderate): and d) bedridden because of nausea (severe). Non or mild state was considered to indicate successful treatment. The efficacy of antiemetic treatment was graded as follows; a) complete response; no vomiting, no worse than mild nausea and receive no rescue antiemetic therapy over the 24h period, b) major response; either one episode of vomiting or moderate/severe nausea or had received rescue medication over 24h period, or any combination of these, c) minor response; two to four episodes of vomiting over the 24h period, regardless of nausea and rescue medication, d) failure; more than four medication. The score of the most symptom was recorded and the total score over 24 hours was summarized. The complete or major response was considered to indicate successful treatment. Results : A total of 10 patients were enrolled into this study, and all were assessable for efficacy analysis. Total nausea control was achieved in 90$\%$ (9/10:none=60$\%$ plus mild=30$\%$) of total patients after 7 days. The control of vomiting by granisteron was noted in seven patients (70$\%$) of complete response and three (30$\%$) of major response with a hundred-percent successful treatment over 7 days. The minor response or treatment failure were not observed. No significant adverse events or toxicities from granisetron were recorded in patient receiving granisetron. Conclusion : We concluded that granisetron is a highly effective antiemetic agent in controlling radiotherapy-induced nausea or vomiting with a minimal toxicity profile.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.100-112
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• 1999

Objective：In life-long disabilities like autism and mental retardation, the authors thought that it is important for clinician to consider the quality of life of a primary caregiver for long-term management and prognosis. This study was to investigate the factors of children and family environment affecting the quality of life and depression in mothers with autistic and/or mentally retarded children. Methods：41 autistic and/or mentally retarded children aged 5-12 years with their mothers were surveyed from September, 1998 to January, 1999, with K-CBCL, K-BDI, K-FES, and K-SBQOL scale and compared with data from 35 normal control subjects. Results：1) Total K-BDI and K-SBQOL scores of mothers with mentally handicapped children were significantly poorer than the scores of normal control group. Independence, intellectual/cultural orientation and active recreation subscales of K-FES in mentally handicapped children were significantly decreased than those in normal control group. 2) Total K-BDI score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially internalizing and thought symptoms, and with family cohesion, expressiveness, conflict and independence. 3) Totol K-SB quality of life score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially attention problem, and with family cohesion, conflict, independence, intellectual/cultural orientation, and moral-religional emphasis. 4) The quality of life of mothers with mentally handicapped children was predicted by attention problem($R^2$=.36, p=.000) and social competence($R^2$=.07, p=.038) in children and family cohesion ($R^2$=.16, p=.001). 5) Depression of mothers with mentally handicapped children was predicted by internalizing symptom ($R^2$=.21, p=.003) and thought disorder($R^2$=.06, p=.048) in children and family cohesion($R^2$=.14, p=.008). Conclusion：Reducing behavioral problems and family therapeutic intervention in autistic and mentally retarded children can improve the quality of life of primary caregivers and long-term prognosis of the children, although those are not curative.

• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.256-268
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• 1992

This survey was conducted from January 1991 to May 1991. Two hundred arid eight residents in 4 government supported homes for the aged and two hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale(CADS) and somatization symptom check list(SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and un satisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.559-569
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• 2020

This study was conducted to examine relationships among job environment, psychological work demand, fatigue, musculoskeletal symptoms, then to investigate the factors influencing musculoskeletal symptoms of care workers in long-term care hospitals. A total of 128 care workers recruited from three long-term care hospitals in S city. Self-reported questionnaire survey was conducted from April to May, 2020. The results were as follows: The musculoskeletal symptoms of the care workers were the sum of the frequency of symptom occurrence, duration of symptoms, and intensity of pain in the three parts of the shoulder, hand/wrist/finger, and waist. The average score was 11.41±9.50 points out of 42. According to the hierarchical regression analysis, their musculoskeletal symptoms were significantly influenced by working department(β=.18, p=.034), psychological work demand(β=.21, p=.013) and fatigue(β=.25, p=.003), explained 21.6% of the total variance(F=6.87, p<.001). Based on our results, in order to reduce musculoskeletal symptoms of care workers in nursing hospitals, it is necessary to develop and apply an intervention program that can reduce psychological work demand and fatigue in consideration of the severity of the patient in charge.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1100-1118
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• 2020

Objectives: The purpose of this study was to assess the effects of acupuncture as a treatment for allergic rhinitis (AR). We used a meta-analysis and systematic review to analyze the results of randomized controlled trials (RCTs) that applied acupuncture to AR patients. Methods: The key question assessed the effects of acupuncture on patients with AR, and we included only RCTs. We searched the KoreaMed, NDSL, KMBASE, Koreantk, OASIS, PubMed, EMBASE, and Cochrane databases, with no language restriction. We assessed risk of bias with the Cochrane Risk of Bias tool. The random effects model was used to adjust for the heterogeneity of the included studies, and the effect sizes between two groups were reported as mean differences (MD) and risk ratios (RR). Results: Twelve RCTs were analyzed, with a total of 1788 participants; 824 participants were in the treatment group (i.e., acupuncture) and 964 were in the control group (sham acupuncture, western medicine, or waitlist). The meta-analysis results of 7 RCTs comparing the therapeutic efficacy of acupuncture with that of sham acupuncture showed a statistically significant difference (p<0.05) in the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Change of Total Nasal Symptom Score (TNSS). The meta-analysis of 4 RCTs comparing the therapeutic efficacy of acupuncture with western medicine showed statistically significant differences (p<0.05) in the RQLQ but not in the changes in effective rate (p>0.05). Conclusions: Acupuncture can be an effective treatment for AR, but more studies are required to enhance the level of evidence and to confirm safety.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.30-37
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• 2004

The objective of this study was to make a comparison between chronic superficial gastritis and gastric ulcer patients regarding stress responses, anger expression and alexithymia. The subjects included 100 patients with chronic superficial gastritis and 40 patients with gastric ulcer confirmed by gastroscopy. Stress responses were measured by the Stress Response Inventory(SRI) and anxiety, depression, somatization and hostility subscales of the Symptom Checklist-90-revised(SCL-90-R). Anger expression and anger suppression were assessed by the Anger Expression Scale. The level of alexithymia was assessed by the Toronto Alexithymia Scale(TAS). Multiple regression analysis showed that the patients with chronic gastritis scored significantly higher on tension subscale and somatization subscale of the SRI, and anxiety subscale of the SCL-90-R than those with gastric ulcer. However, no significant differences were found in the score of anger expression and anger suppression subscales and total score of TAS between the two groups. In chronic gastritis patients, women scored significantly higher on somatization subscale of the SRI than men, whereas in gastric ulcer patients, men scored significantly higher on somatization subscale of the SRI than women. These results suggest that chronic gastritis patients are more likely to have higher level of stress responses and higher susceptibility to stress than gastric ulcer patients. In addition, in chronic gastritis patients, women are more likely to somatize than men, but in gastric ulcer patients, men are more likely to somatize than women. However, there were no differences between the two groups in anger expression, anger suppression and alexithymia.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.184-193
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• 2007

Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.100-106
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• 2007

Objectives : The objective of the present study was to investigate alexithymia in major depressive disorder(MDD) and subclinical depression(SCD). Methods : Three hundred eighty-six community-dwelling adults(238 females and 148 males, age 19-79; mean age $43.0{\pm}13.9$) were recruited. Structured clinical Interview for DSM-IV(SCID) was conducted for the diagnosis of MDD or other Axis I psychiatric disorders. The Center for Epidemiological Studies for Depression Scale(CES-D) and the Totonto Alexithymia Scale(TAS) were administered to assess depressive symptom and alexithymia, respectively. Among subjects without MDD, those who had minor depressive disorder on the SCID or high scores(i.e. over 16) on the CES-D were defined as subjects with SCD. TAS total score and factor I, II, III scores of TAS in MDD, SCD, and non-depressive controls were compared. Results : Among 386 subjects, 38 subjects(9.8%) were diagnosed as MDD by DSM-IV criteria, while 57 subjects(14.8%) were classified into SCD group. There were significant differences between 3 groups(MDD, SCD and non-depressive controls) in total score($F_{2,383}=14.0$, p<0.01), factor I(difficulty in identifying feeling)($F_{2,383}=23.4$, p<0.01) and factor II(difficulty in describing feeling)($F_{2,383}=7.8$, p<0.01), but not factor III(external oriented thinking)($F_{2,383}=1.8$, p=0.16) of TAS. In post-hoc analysis, both MDD subjects and SCD subjects had higher scores in TAS total, factor I and factor II, compared to non-depressive controls(all p<0.01). In contrast, there were no significant differences between MDD subjects and SCD subjects in any TAS factor. Conclusion : In this study, both MDD subjects and SCD subjects were more alexithymic than non-depressive control subjects. These findings suggest that SCD, as well as MDD, is also related to alexithymia.