• The Journal of Internal Korean Medicine
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• v.43 no.3
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• pp.477-484
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• 2022

Objective: The purpose of this study was to report the improvement effect of symptoms of integrative cancer treatment (ICT) on recurrent gallbladder cancer patients. Methods: A 73-year-old patient with recurrent gallbladder cancer visited the Daejeon Korean Medicine Hospital of Daejeon University East West Cancer Center (EWCC) on February 2022. After the diagnosis of gallbladder cancer, the patient underwent cholecystectomy and relapsed during follow-up. After the operation, the cancer recurred during follow-up, and after radiation treatment, she had been receiving ICT since February 2022. The clinical outcomes were measured by X-ray, computed tomography (CT), laboratory findings, including tumor markers (CEA, CA19-9), and numeric rating scales (NRS). Results: After treatment, abdominal pain was relieved from NRS 5 to 2, and abdominal circumference decreased from 74.5 to 67. During and after treatment, we found neither hepatotoxicity nor nephrotoxicity in the laboratory findings. Conclusion: This case study suggests that ICT may improve symptoms in patients with gallbladder cancer.

• Journal of Oriental Neuropsychiatry
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• v.33 no.3
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• pp.259-266
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• 2022

Objectives: The combination of Harm-Avoidance (HA) and Self-Directedness (SD) of Temperament and Character Inventory (TCI) has been reported pivotal for mental health; however its clinical usefulness in integrative medicine has not sufficiently reported. The purpose of this study was to illustrate multi-phasic mental health of subjective satisfaction with life, emotional well-being, and psychopathology, following the HA-SD profile groups. Methods: A total of 527 Korean university students reported HA and SD scores as to render their HA-SD profile, and multi-phasic mental health characteristics using Satisfaction with Life Scale (SWLS), Positive Affect and Negative Affect Schedule (PANAS), and Beck Depression Inventory (BDI) with composite well-being scales of SC (Sum of Self-Directedness and Cooperativeness score) and HI (Happiness Index, subtraction of Negative Affect (NA) score from Positive Affect (PA) score) as standardized. Pearson's correlation was used to report correlation coefficient, and the ANCOVA with age and sex as covariates, to show significant differences in mental health and well-being between the HA-SD profile groups. Results: The HA-SD profile groups showed distinctive multi-phasic mental health characteristics; health related scores of SWLS, PA, SC and HI decreased following the order of hS (low HA and high SD), HS (high HA and high SD), hs (low HA and low SD) and Hs (high HA and low SD) profile groups; however the non-health related scores of NA and BDI showed contrasting order. Conclusions: The HA-SD profile was found to be clinically useful for examining multi-phasic mental health and well-being status, and the TCI may be an imperative personality inventory for integrative medicine.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.296-311
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• 2023

Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.

• Journal of Korean Clinical Nursing Research
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• v.30 no.1
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

• The Journal of Korean Obstetrics and Gynecology
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• v.37 no.3
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• pp.63-84
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• 2024

Objectives: This study aims to understand the stress patterns and coping behaviors of women with infertility and to improve existing infertility stress assessment tools to develop a tool suited for Korean society. Methods: The study involved 10 women diagnosed with primary or secondary infertility. Data were collected through surveys and in-depth interviews. Participants were recruited voluntarily, and snowball sampling was used for additional recruitment. Data collection occurred from September 2023 to April 2024. Data analysis included Spearman's rank correlation, Mann-Whitney U test, and Kruskal-Wallis test. Interview results were analyzed using text mining and network analysis with Python 3.12. Results: There was a significant correlation between IVF/ICSI treatment and resilience scores, with non-IVF/ICSI groups showing higher resilience scores. Existing infertility stress assessment tools were generally useful but had limitations, such as discomfort with religious expressions and fixed gender roles, as well as issues with the number of items and response scales. Text mining of interview responses revealed key stress-related keywords including worry, depression, burden, pregnancy outcome, and health. Main stressors included uncertainty about pregnancy outcomes, physical discomfort during treatments, economic burdens, and emotional reactions from family and social relationships. Conclusions: This study identified the stress patterns of women with infertility through interviews. It showed the need for a new assessment tool to evaluate and support the complex stressors experienced by these women. Developing a comprehensive tool is essential for better understanding and managing the various stress factors faced by infertile women.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.35-43
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• 2018

Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.155-163
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• 2019

Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.

• Journal of Oriental Neuropsychiatry
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• v.20 no.3
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• pp.169-188
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• 2009

Objectives : The purpose of this research is to examine the effect of Bunsimgi-eum on the chest discomfort of Hwa-byung's major symptom. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Bunsimgi-eum or controlled medication for major symptoms of Hwa-byung. As preparatory research, 100 mm Visual Analogue Scale(VAS) for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, Korean State-Trait Anger Expression Inventory(STAXI-K), Korean State-Trait Anxiety Inventory(STAI-K), Korean Beck's Depression Inventory(BDI-K) and Heart Rate Variability(HRV) were also measured as the 2nd evaluative instrument at the before treatment. Results : Clinical characteristics-vital signs & demographic characteristics showed no significant difference between both groups. The characteristics of disease-chief complaint, pattern Identification, period, etiological factor, etc, also showed no significant difference between both groups. There were almost no Coincidence between pattern identification & weight of Hwa-byung's major symptoms. The results of Chest PA, EKG and clinicopathologic examination showed no significant difference between both groups. There were no significant difference between both groups in all valuation scales; 100 mm Visual Analogue Scale for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, STAXI-K, STAI-K, BDI-K and HRV. Conclusions : We considered that establishment of experimental group and controlled group was objective and worth conducting this research. And this methodology is expected to be applied to the subsequent research. And also, we hope to make up for this study through various study and discussion.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.60-65
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• 2001

Objective : The popular grading systems in use, such as Hunt-Hess grade and Fisher scale score, are based primarily on the patient's clinical conditions or computerized tomography score after aneurysmal subarachnoid hemorrhage(SAH). The author investigated whether the need for ventriculoperitoneal(VP) shunt for chronic hydrocephalus and outcome can be predicted by Hunt-Hess grade and Fisher scale. Methods : A series of 146 patients admitted to our hospital from August 1991 to July 1999, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage which required shunting. Patients were evaluated based on following factors : Hunt-Hess grade, Fisher scale, age, sex, hypertension, aneurysm location, and intervals from aneurysm rupture to operation. Results : The overall mortality rate of the study group was 8.2%. Hunt-Hess grade(p=0.001) or Fisher scale (p=0.001) at all pretreatment times was significantly correlated with outcome. In addition, there was an increased risk of poor outcome in older age(65<). However, there were statistically no significant relationship between outcome and sex, location of aneurysm, hypertension, and interval from aneurysmal rupture to operation(p>0.05). Of 134 surviving patients, 16 patients(12%) underwent VP shunt placement secondary to chronic hydrocephalus. Hunt-Hess grade(p=0.001) is more predictive of chronic hydrocephalus than Fisher scale(p=0.146). Aneurysm location was significantly correlated with development of chronic hydrocephalus (p<0.05), without significant correlations in sex, age, hypertension. IVH, and ICH. Conclusion : This study suggests that there is a high clinical correlation between outcome and Hunt-Hess grades and Fisher scales on admission, but Hunt-Hess grade is more predictive for chronic hydrocephalus than Fisher scale. In addition, age(<65 yrs) is the significant factor for prediction of outcome. There was a trend of increasing risk for chronic hydrocephalus according to aneurymal location.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.2
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• pp.376-380
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• 2004

The purpose of this study is the develop a questionnaire for measuring Yin-Deficiency and examine the reliability and validity for its' value as a barometer for evaluating Yin-Deficiency. Questionnaire was developed according to the symptoms of Yin-Deficiency suggested in the 'Standardization of diagnostic terms and requirements of Korean Medicine', With and as a reference, each symptom has been worked on to be put on the questionnaire. Visual analogue scales(VAS) was used as a barometer for measuring frequency of manifestation of symptoms. A study was performed to measure validity and reliability of the final questionnaire for analysis. reliability of YinDQ was measured by Cronbach's alpha coefficient and test-retest method. This study utilized factor analysis and clinical validity for evaluation of validity. For the purpose of decreasing the amount of data-the number of factors, and at the same time minimize the loss of information factor analysis was performed Component factors were extracted using Principal Component Analysis. This study evaluated the clinical validity for examination of difference between the normal group and the patient group. Evaluation on the's internal consistency showed strong internal consistency with value of 0.8615. reliability from test-rest with three-week interval, followed by comparisons of the correlation coefficient and mean values of each item between the two. The Spearman correlation coefficient was 0.54-0.79. By factor analyse two factors with Eigen value of greater than 2.2 were selected. Factor 1 consists of items of 'irritable fever on the five Hearts', 'flushing of the zygomatic region in the afternoon', 'tidal fever', 'night sweats', and 'dryness on the mouth or the throat'. Factor two consists of items of 'emaciation', 'dizziness', 'insomnia', 'decreased amount of urine with yellowish color', and 'constipation'. The comparison between the patient group and the normal group showed significant differences for every ten questions. The results implies that YinDQ is a barometer with sufficient reliability and validity. The questionnaire for Yin-Deficiency may not be enough to replace the specific differential diagnosis by a doctor of Oriental medicine. Nevertheless, it can be effectively utilized as an assisting method in consultation or a method of measuring the degree of Yin-Deficiency in a group.