• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.957-961
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• 2014

Purpose: With regard to the protective effect of vitamin D against colorectal cancer (CRC), we evaluated genetic variants that might influence vitamin D metabolism: vitamin D receptor (VDR), vitamin D binding protein (GC), vitamin D 25-hydroxylase (CYP2R1), and vitamin D 25-hydroxy 1-alpha hydroxylase (CYP27B1). Materials and Methods: A total of 657 subjects, including 303 cases with CRC and 354 controls were enrolled in this case-control study. All 657 were genotyped for the four gene variants using PCR-RFLP methods. Results: In this study, no significant difference was observed for VDR (rs2238136), GC (rs4588), CYP2R1 (rs12794714), and CYP27B1 (rs3782130) gene variants in either genotype or allele frequencies between the cases with CRC and the controls and this lack of difference remained even after adjustment for age, BMI, sex, smoking status, NSAID use, and family history of CRC. Furthermore, no evidence for effect modification of the variants and CRC by BMI, sex, or tumor site was observed. Conclusions: Our findings do not support a role for VDR, GC, and CYP27B1 genes in CRC risk in our Iranian population. Another interesting finding, which to our knowledge has not been reported previously, was the lack of association with the CYP2R1 gene polymorphism. Nonetheless, our findings require confirmation and possible roles of vitamin D metabolism-related genes in carcinogenesis need to be further investigated.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5927-5936
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• 2014

Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

• 대한간호학회지
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• 제4권1호
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• pp.121-134
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• 1974

This study is an attempt to evaluate the use of an oral contraceptive by: 1. Deforming the acceptance rate of the oral contraceptive according to socio-demographic characteristics 5. Estimating the duration of the use of the contraceptive f. Discovering reasons why the contraceptive was discontinued 4. Computing the cumulative continuation and discontinuation rate according to socio-demographic characteristics, history of pregnancies, and attitude of husband at the time of selection of the contraceptive. One hundred sixty-eight women of child bearing age (14-49 years), residing in Yonhee Dong, Seoul, Korea and registered as oral contraceptive accepters at Yonsei Community Health Center, were interviewed during a three week period in 1973. The questionnaire was designed to determine the socio-demographic characteristics of the oral contraceptive accepters, the current status of their family planning practice, medical reactions if any, discontinuation practice, and the duration of the use of the contraceptive. The major findings of the study were as follows; 1. The acceptance rate was highest for women between 30 and 34 years of age, the mean age being 34.4 years. 2. Fifty six point five percent of all respondents said that thirty years of age was the ideal age to stop having children. 3. The average number of living children was 3.5 and fifty four point eight percent of respondents felt 2 boys and I girl was the ideal number of children. 4. The average number of pregnancies was 5.2 and the average number of induced abortion was I. 4. 5. Fifty eight point eight percent of the respondents had experience in the use of contraceptive methods in the past. 6. Forty one point seven percent of the respondents replied that they chose the oral contraceptive because, "it was not complicated to use." 7. Sixty four point eight percent of the women said their husband approved of their taking the pill. 8. The cumulative discontinuation rate was sixty point five percent of the total respondents for one year in first segment. 9. Sixty six point nine percent of the respondents had experienced side-effect while using the pill. The side effects for 68.9 percent of these women were castro-intestinal upsets. Twenty point eight percent of the women who had side effects consulted with medical personnel about them. Women who had more education had more side effects. 10. Seventy three point two percent of the women who discontinued the pill did so because of medical reasons. Women who were younger discontinued the pill for personal reasons more-often than older women. Among personal reasons listed for discontinuing the pill was the attitude of the husband. 11. The average duration of continuance of the contraceptive was 5.3 cycles under 29 years of age; 7.4 cycles between 30 and 34 years of age; and 8.4 cycles over 40 years of age. 12. The discontinuation rate was seem to increase sharply in the early cycle and increase more slowly in later cycle. Conclusions and suggestions: Since the attitude of the husband was shown to be important, the current family planning program should be expended to include approach to husband. For women who must use the oral contraceptive, education and support must be enhanced so that the discontinuation rate due to side effects will be decreased.

• 한국융합학회논문지
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• 제9권8호
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• pp.109-116
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• 2018

본 연구의 목적은 D시에 거주하는 독거노인들을 대상으로 행복과 경제활동의 참여욕구의 관계를 알아보고자 하였다. 연구방법은 질적 연구방법을 사용하였다. 연구 참여자는 D시 노인복지관에 다니거나 복지관에서 봉사활동을 하는 독거 노인을 대상으로 하였다. 연구결과는 두 가지로 요약된다. 첫째, 독거노인들은 복지관에서 실시하는 다양한 프로그램을 즐기고 다른 사람들과 어울리는 것 자체 그리고 가족의 건강이 행복의 요인으로 나타났다. 둘째, 독거노인들은 경제활동 참여에 대한 욕구의 차이가 컸다. 꼭 일을 해서 경제적인 수입을 원하는 노인, 경제적으로 여유로운 노인, 그리고 경제 형편이 어렵지는 않지만 소일거리로 경제활동을 원하는 노인으로 나뉜다. 경제활동에 대한 욕구는 대부분 높게 나타났지만 신체적인 한계를 고려해서 하루에 2-3시간 정도의 활동을 원했다. 소득의 경우도 소득을 간절히 원하는 경우와 현재의 생활비가 충분하다는 반응이 나타났다. 본 연구는 독거노인의 경제적인 측면과 심리적인 측면의 제도적인 지원정책을 선순환적으로 마련할 수 있는 방안을 제시하였다.

• 한국보건간호학회지
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• 제17권1호
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• pp.83-95
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• 2003

The purpose of this study was to provide basic data for nursing interventions to promote rehabilitation motivation by identifying the influencing factors of motivating rehabilitation intention in patients with spinal cord injury. The data were collected using self-reported questionnaires and questionnaires by postal mail services, from September 1 through the October 6, 2002. A total of 148 questionnaires were completed and returned. The instrument developed by Han, Hye Sook(2001) was used to measure the rehabilitation motivation, and depression, family support, participation of self-help group, self-esteem, and self-efficacy were measured to test the variables influencing the rehabilitation motivation. Using SPSS WIN 10.0, descriptive statistics, t-test, one-way ANOVA. Turkey inspection, Pearson's correlation coefficient, and stepwise multiple regression analysis was conducted. The results of the study are as follows: The rehabilitation motivation score ranged from 30 to 100, and the average was $76.78(\pm12.40)$. In terms of the types of motivation, mean task-oriented motivation score was $23.28(\pm3.39)$, change-oriented motivation $22.25(pm3.16)$, obligatory motivation $9.90(\pm2.02)$, external motivation $9.85(\pm1.89)$, and mean amotivation score was $11.50(\pm1.94)$. The scores for the rehabilitation motivation was significantly associated with the time elapsed since injury, economic status, and the degrees of disability. Significant correlations were found between the rehabilitation motivation and the time elapsed since injury(r=-0.222, p=0.007), self-efficacy(r=0.204, p=0.013), depression(r=-0.210, p=0.010). and the economic status(r=-0.189, p=0.022). The variables that can predict the rehabilitation motivation included the time elapsed since injury, and self-efficacy. These variables accounted for $12.8\%$ of the variance of the rehabilitation motivation. In conclusion, the factors influencing the rehabilitation motivation in patients with spinal cord injury were found to be the time elapsed since injury, self-efficacy, depression, and the economic status of the patient, Accordingly, nursing interventions which could alleviate patients' depression and enhance self-efficacy should be designed to motivate rehabilitation. Before planning nursing interventions for patients with spinal cord injury, needs assessment should be conducted including the assessment of patients' economic status and time elapsed since injury.

• 한국노년학
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• 제31권4호
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• pp.985-998
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• 2011

본 연구는 노인장기요양보험제도 도입 이후 주야간보호사업소 운영현황을 파악하고 가동률 관련 요인을 탐색하고자 하였다. 전국 주야간보호사업소에 2010년 7월 14일에서 7월 28일까지 설문지를 우편 발송하여 설문에 성실히 응답한 277개소의 조사지를 분석하였다(응답률 24.5%). 사업소의 운영주체는 법인이 219개소(79.1%), 개인이 48개소(17.8%), 국공립 등이 10개소(3.6%)이었으며, 평균 가동률은 국공립 등은 79.08%, 법인은 72.49%인 반면, 개인운영 사업소는 57.58%로 낮았다. 사업소 운영주체별로 전체 인력 수에는 차이가 없었으나, 국공립 사업소는 간호사 수가 1.07명인데 비해 개인 사업소는 0.08명으로 유의한 차이가 있었다. 법인 및 국공립사업소가 개인사업소보다 프로그램 실시율이 높았고, 신체활동, 음악활동, 물리치료, 레크레이션, 작업치료 등에서는 통계적으로 유의한 차이가 있었다. 본 연구결과에 기초할 때, 개인운영 사업소와 2008년 이후에 설립된 사업소에 대해 대상자 평가 및 모니터링, 프로그램 실시에 대한 교육훈련 및 서비스 질 관리를 강화할 필요성이 제기된다. 또한, 주야간보호서비스 이용자의 가족에 대한 실효성 있는 지원을 강화하여 주야간보호서비스에 대한 수요를 확대해야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8607-8612
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• 2014

Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

• Journal of Hospice and Palliative Care
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• 제12권3호
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• pp.132-138
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• 2009

목적: 말기 암환자 돌봄의 질을 향상시키기 위해서는 호스피스 완화의료 전문인력을 위한 적절한 교육이 필수적인 요소이다. 보건복지가족부 내 말기 암환자 TF 위원회에서는 2005년에 호스피스 완화의료 전문인력에게 필요한 기본조건으로서 60시간 이상의 호스피스 완화의료 교육을 받도록 제시한 바 있다. 이에 국내 호스피스 완화의료 전문인력의 교육현황을 알아보고, 교육실태에 있어서 지역적인 변이가 있는지를 밝히고자 본 연구를 시행하였다. 방법: 2008년 보건복지가족부가 실시한 말기 암환자 전문기관 활성화 지원사업에 지원한 호스피스기관 중 46개 기관의 전문인력 673명의 교육현황 자료를 분석하였다. 결과: 총 673명 중에서 60시간 이상의 호스피스 완화 의료 교육을 이수한 경우는 279명(41.5%)이었다. 간호사 378명 중 60시간 이상 교육을 이수한 경우는 177명(46.8%)이었으며, 의사는 106명 중 38명(35.8%), 사회복지사는 75명중 24명(32.0%), 성직자는 114명중 40명(35.1%)이었다. 60시간 이상의 교육을 이수한 경우는 경상도 지역이 다른 지역에 비하여 상대적으로 적었다. 또한 중소도시에 소재한 기관의 전문인력은 대도시에 소재한 기관의 전문인력보다 60시간 이상 교육을 이수한 비율이 낮았다. 기관 종류에 따라서는 병원에 근무하는 호스피스 완화의료 전문인력이 60시간 이상의 교육을 이수한 경우가 상대적으로 적었다. 결론: 본 연구의 결과 60시간 이상 호스피스 완화의료 교육을 이수한 전문인력은 전체의 41.5%였으며, 지역적으로 변이가 있는 것을 알 수 있었다. 앞으로 호스피스 완화의료 전문인력을 위한 교육을 활성화하고 지역적인 불균형을 해결하기 위한 제도적 대안이 요구된다. Train-the-trainer 모델을 기반으로 호스피스 완화의료 전문인력을 위하여 개발한 60시간의 교육 프로그램을 운영하는 것이 바람직한 대안이 될 수 있을 것이라고 생각한다.

• 대한감각통합치료학회지
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• 제17권1호
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• pp.30-42
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• 2019

목적 : 본 연구는 자해행동을 보이는 자폐스펙트럼장애의 비약물적 치료 중심으로 실시한 연구를 대상으로 체계적으로 분석하여 작업치료 임상현장에서 동일한 문제를 보이는 자폐스펙트럼장애 아동에게 적절한 서비스를 제공하기 위한 근거를 마련하고자 한다. 연구방법 : 전자데이터 베이스인 PubMed, Medline, DBpia, RISS, KISS, NDSL을 사용하여 2008년 10월부터 2018년 11월까지 국내외 학회지에 게재된 연구를 대상으로 검색하였다. 주요 용어는"(Autism OR Autism Spectrum Disorder) AND (Therapy OR Treatment OR Intervention) AND (Self Injurious Behavior)"으로 검색하였고, PICO형식과 근거수준을 사용해 분석하였다. 연구결과 : 총 12편의 논문이 선정되었고, 근거의 질적 수준은 대상연구 논문 12편 중 수준 IV와 수준 V가 가장 많았으며, 실험설계는 단일대상연구가 많았다. 중재의 종류는 행동치료가 가장 많았다. 분석결과 자폐스펙트럼장애의 자해행동은 행동치료와 뇌자극 및 조절기법, 행동치료와 병행한 감각통합치료로 자해행동을 감소시켰으며 통계적으로도 유의한 결과를 보였다. 결론 : 자해행동을 보이는 자폐스펙트럼 장애 아동에게 적용한 비약물적 중재에 대한 근거자료를 제시하였다. 앞으로 자폐스펙트럼 장애 아동의 자해행동에 대한 중재효과성을 증명하기 위하여 근거수준이 높은 연구 설계와 다양한 비약물적 중재간의 차이점을 밝히는 연구가 지속적으로 이루어져야 할 것이다.

• 한국노년학
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• 제39권4호
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• pp.741-762
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• 2019

본 연구는 지역사회에 거주하는 노인 1인 가구의 노인영양지수(Nutrition Quotient for Elderly, NQ-E)를 파악하고, 영양 수준에 영향을 미치는 생활실태 특성을 규명함으로써 노인 1인 가구가 지역사회 내에서 건강한 노후를 영위할 수 있는 개입 방안을 고찰하고자 실시되었다. 조사 대상은 전국에 만 65세 이상 1인 단독가구 노인 1,970명을 편의표집방법으로 조사하였으며, 사회복지기관 25곳과의 조사 협조체계를 구축하고 독거노인생활관리사 385명이 설문조사 요원으로 참여하였다. 조사 결과 노인영양지수(NQ-E)는 평균 51.14점으로 '하' 등급'을 나타냈으며, 다중회귀분석의 설명력은 20.1%로 나타났다. 유의미한 변인으로는 여성인 경우, 연령이 낮을수록, 동부에 거주하는 경우, 주관적 건강상태가 좋은 경우, 복약 수가 적을수록, 비흡연자인 경우, 과음주가 아닌 경우, 경제상태 만족도가 좋은 경우, 식비 비중이 30% 이상인 경우, 무학이 아닌 경우, 가족 및 이웃과의 교류가 많을수록 노인영양지수(NQ-E)를 높이는 예측변인이 됨을 알 수 있었다. 본 연구결과를 근거로 향후 노인 1인 가구의 영양관리 및 향상을 위한 포괄적인 대책이 모색되어야 할 것이다.