• 수면정신생리
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• 제3권2호
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5133-5138
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• 2016

Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran.This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group's mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women's health and reduce deaths due to breast cancer.

• 대한불안의학회지
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• 제5권2호
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• pp.125-132
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• 2009

Objective : This study examined psychiatric characteristics of wounded persons of Daegu subway fire accident occurring in February 2003 after six years. Methods : 103 wounded persons completed psychometric measures at 2 months and 6 years after the accident. Changes of psychiatric symptoms were compared and factors affecting post-traumatic stress disorder (PTSD) seriousness were examined. Results : In Minnesota Multiphasic Personality Inventory, the scores of Psychopathic Deviate (Pd), Masculinity/ Femininity (Mf), Social Introversion (Si) scales were significantly changed over time. The scores of Symptoms Checklist-90-Revision subscales were mostly decreased over time, however, paranoid ideation (PAR) subsclae scores were not significantly changed over time. In all of the State-Trait Anxiety Inventory (STAI)-State, Beck Depression Inventory, Impact of Event Scale, and PTSD Checklist-Civilian, mean scores at 6 years after the accident were significantly lower than those at 2 months after the accident. However, STAI-Trait score was not significantly changed over time. Total seriousness of PTSD was found to be affected by quality of sleep. Conclusions : Psychiatric symptoms of subjects were largely improved over time, but distrust and doubt of others were continued. In addition, the wounded persons suffered from sleep problems. Therefore, early and continuous interventions of public institutions and public health specialists are needed for the wounded persons with chronic psychiatric disorders.

• Nutrition Research and Practice
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• 제8권1호
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• pp.94-102
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• 2014

Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5845-5851
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• 2014

Reducing fear of cancer is significant in developing cancer screening interventions, but the levels of fear may vary depending on the degrees of media exposure as well as individuals' socioeconomic positions (SEP). However, few studies have examined how the SEP influences the fear of cancer under the moderating process of general and specific forms of media exposure. We investigated the moderating effect of media exposure on the relationship between SEP and the level of fear of cancer by assuming that cancer knowledge is a covariate between those two. In particular, this study examined how exposure to both general and specific media changes the series of processes from SEP to fear of cancer. We conducted path analyses with three types of media - television, radio and the Internet- using data from a health communication survey of 613 adults in Massachusetts in the United States. We found that SEP influences cancer knowledge directly and fear of cancer indirectly, as moderated by the level of media exposure. Health-specific exposure, however, had a more consistent effect than general media exposure in lowering the fear of cancer by increasing knowledge about cancer. A higher level of health-specific exposure and greater amount of cancer knowledge lessened the fear of cancer. In addition, the more people were exposed to health information on television and the Internet, the lower the level of fear of cancer as a result. These findings indicate a relationship between SEP and fear of cancer, as moderated by the level and type of media exposure. Furthermore, the findings suggest that for early detection or cancer prevention strategies, health communication approaches through mass media need to be considered.

• 대한간호학회지
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• 제30권2호
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• pp.463-475
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• 2000

The purpose of the study was to identify the effects of inpatient cardiac rehabilitation programs on motivation, the performance of health behavior, and quality of life in patients with coronary artery disease. The subjects consisted of 31 patients who participated in the rehabilitation program during their hospital stay, and were compared with 34 patients who did not participate. The study results are as follows: 1. The mean of cardiac risk factor scores for the subjects was 22.5 (SD = 5.5) at the level of low to moderate risk with some possibility to improve. The physiological and behavioral risk factors for the subjects were also in the normal range or slightly above the normal range. 2. The motivation level to preform health behaviors for both groups was improved after discharge. Also, perceived self-efficacy was significantly higher for the program participants than for the comparison group at the post-test. 3. The performance of cardiac related health behaviors improved for both groups after discharge, but there were no significant differences between the two groups. The program participants reported better performance in most health behaviors at the post-test, but the results failed to reach a statistical significant level. 4. As for motivation and health behavior, the subjects in the both groups showed an improved quality of life after the discharge. In addition, the program participants produced significantly higher scores in health and functioning dimension than the comparison group during the post-test. In conclusion, the study partially supported the effects of the inpatient cardiac rehabilitation program to motivate and improve the quality of life, and provide the need to apply early rehabilitation interventions for the patients after cardiac events. Further study with a longitudinal design is also suggested to verify the effect of cardiac rehabilitation program from hospitalization to discharge and subsequently to fully recover to the level of pre-hospitalized state.

• 종양간호연구
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• 제2권1호
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• pp.36-49
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• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• 한국산업보건학회지
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• 제26권2호
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• pp.210-218
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• 2016

Objectives: The objectives of this study were to investigate female labor workers' occupational stress and musculoskeletal symptoms and to identify the effects of their occupational stress and musculoskeletal symptoms on their health-related quality of life. Methods: A survey was conducted through direct interviews using a musculoskeletal symptoms questionnaire, the Korean Occupational Stress Scale(KOSS), and the Short-Form 36-Item Health Survey(SF-36). Subjects were 112 female labor workers in three factories in D city who were selected by convenience sampling. Results: Factors significantly affecting health-related quality of life were found to be: occupational stress(${\beta}$=-.36); degree of pain, with medium pain(${\beta}$=-.31) and extremely severe pain(${\beta}$=-.24); duration of pain, with more than 1 week-less than 1 month(${\beta}$=-.25) and more than 6 months(${\beta}$=-.16); frequency of pain, with once per 2-3 months(${\beta}$=-.22); responses to pain such as medical leave, use of worker's compensation insurance, task change, etc.(${\beta}$=-.16), and Slightly difficult(${\beta}$=-.16) versus Not hard at all. These variables demonstrated that health-related quality of life is 48%(F=11.72, p<.001) in female workers. Conclusions: To improve female labor workers' health-related quality of life based on the above results, occupational health managers should reduce the workers' occupational stress, develop and apply health interventions regarding musculoskeletal symptoms, prevent the early onset of musculoskeletal symptoms, and protect and promote the workers' health.

• Journal of Chest Surgery
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• 제48권3호
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• pp.187-192
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• 2015

Background: Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. Methods: Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillo-bifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. Results: In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of $21.2{\pm}9.4$ months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up.. Conclusion: To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

• Journal of Chest Surgery
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• 제32권1호
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• pp.38-42
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• 1999

1994년 9월에서 1997년 5월까지 신생아 호흡곤란을 보였던 환아들중 폐외 공기 누출을 나타내었던 48례를 대상으로 그 임상 양상을 분석하였는데 일차성 15례, 이차성 33례를 보였고, 순수 폐간질 기종이 19례, 다른 병변과 동반된 기흉이 19례 있었다. 정상 체중아가 많고 24시간내 증상 발현의 경우가 많았다. 폐 질환으로는 유리질 막증, 태변 흡입 증후군, 폐렴 등이 있었다. 25.2%의 원내 사망율을 보였고 유리질막증 환자에서 많았다.