• Journal of muscle and joint health
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• v.1 no.1
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• pp.1-30
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• 1994

Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS $PC^+$ program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.

• Journal of muscle and joint health
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• v.2 no.1
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.231-242
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• 2023

This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.

• Health Policy and Management
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• v.34 no.3
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• pp.271-281
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• 2024

Background: The unmet healthcare needs (UHNs) of people with disabilities (PWD) are not only detrimental to their quality of life but also can lead to serious health outcomes including death. A variety of factors including socioeconomic, personal, and environmental factors affect UHNs for PWD. Previous studies focused on individual socioeconomic and disability characteristics as influencing factors. Our studies included environmental factors that have a significant impact on the use of healthcare service by PWD. Methods: We analyzed the UHNs status and influencing factors among 4,326 adults with disabilities using the Korea Disability Life Data. Chisquare analysis identified differences in UHNs by general, disability, and environmental characteristics. Logistic regression determined factors affecting UHNs. Results: Those with low educational level (adjusted odds ratio [aOR], 1.229; 95% confidence interval [CI], 1.024-1.475), those with low income level (aOR, 1.416; 95% CI, 1.015-1.976), those who enrolled in private insurance (aOR, 1.234; 95% CI, 1.018-1.496), those who need help with daily living (aOR, 1.298; 95% CI, 1.059-1.592), those who did not go out (OR, 1.566; 95% CI, 1.274-1.924), those who use taxis (aOR, 1.407; 95% CI, 1.047-1.891) or call taxi for people with disabilities when going to the hospital (aOR, 1.370; 95% CI, 1.001-1.875), the communication disabled (aOR, 1.304; 95% CI, 1.029-1.651), those with poor subjective health status (aOR, 1.248; 95% CI, 1.043-1.494), those who felt the explanation of treatment results was insufficient (aOR, 4.035; 95% CI, 1.365-11.927), hose dissatisfied with healthcare services (aOR, 3.515; 95% CI, 2.741-4.508) were more likely to experience UHNs. Conclusion: Effective healthcare service provision for PWD requires not only financial assistance but also social support, along with education for healthcare staff, policies that consider the characteristics of disabilities.

• Journal of Radiation Protection and Research
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• v.39 no.3
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• pp.142-149
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• 2014

Korea conducts a national health screening program to improve and check-up on public health and in recent years, the screening usage has been increased. Given the increased screening usage for radiographic exams, this study predicts the frequency of using radiographic exams and the exposure dose. This study estimates the usage of radiographic exams by isolating radiographic exams from the 2011 analysis of the national health insurance corporation, and estimates the public exposure dose by applying each procedure's dose table from UNSCEAR 2008. As a result of the analysis, in the 2011 National Health Screening, the average exposure dose per person is assumed to be 0.57 mSv, and depending on the type of screening program from the radiographic exam, an examinee could be exposed to between 0.2 mSv and 11.081 mSv. The frequency of using radiographic exposure was found to be 16,005,914 and the exposure dose was 6,311.76 person-Sv. The most frequent exam is the Chest X-ray, which was performed 1,070,567 (69.17%), and the UGI has the highest exposure dose at 5,217.94 person-Sv (82.67%). The outcome is categorized based on gender and age, excluding those under 39 years old. In all age groups, the screening usage and exposure dose are higher in females than in males. In particular, females between 50 and 54 years old have the highest screening usage (1,674,787, 10.5%) and exposure dose (701.59 person-Sv, 11.1%). As UGI accounts for 82.76% of procedures, except when done for medical purposes, if the government supports a voluntary UGI exam (which includes the UGI exam in the National Screening Program) or abolishes it completely, as seen overseas, the cost-effectiveness and validity of the UGI exam, as well as the exposure dose from the National Screening Program will all decrease significantly.

• Research in Community and Public Health Nursing
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• v.14 no.4
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• pp.568-578
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• 2003

This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

• Journal of muscle and joint health
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• v.5 no.1
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• pp.57-71
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• 1998

This study purports to examine sociodemographic characteristics and those factors associated with osteoarthritis in women experiencing the disease in order to make suggestions for the prevention and management of osteoarthritis in women. The subjects were 143 women who were diagnosed to have osteoarthritis and under follow-up care at an outpatient department of a university-affiliated hospital. The data were collected through personal interviews by using the structured questionnaire between October 6 and October 24, 1997. The degree of daily living activities was measured with 24 items, which were made based upon Katz Index, Barthel Index and Functional Status Index. Each item has 4 response categories : (1) being able to do alone with any difficulty, (2) being able to do alone with some difficulty, (3) being able to do alone with the help of a person or an instrument, (4) not being able to do at all. The data was analyzed with correlation analysis, t-test, ANOVA, and regression analysis. The results are summarized as follows : 1. As for the age of the subjects, 59.4% were between 45 and 64 years, while 28% were 65 years and above. The subjects having religion were 71.7% and 44.1% of the subjects were protestants. The educational level was low : 31.5% graduated from elementary school, while 30.1% had no formal education. Those married subjects were 72%. Fifty nine percent of the subjects evaluated their economic status as middle class. 2. Those people from whom the subjects currently receive some help were spouses in 35.8% of the subjects. Likewise, 50% of the subjects indicated spouse as the people from whom they want to receive help. 3. The score of the ability of daily living activities ranged between 48 and 96, with the mean of 78.94. Those means of physical activity, ADL(activities of daily living) and IADL(instrumental activities of daily living) were 14.89, 13.97 and 50.09, respectively. Except for the items of carrying heavy stuff and of washing clothes in the sitting position the subjects showed independence in more than 90% of the items, where Independence is defined as being able to do alone or with the help of a person or an instrument. 4. The increase in age was a significant predictor of the decrease in the ability of daily living activities. Those graduated from middle school and above showed a significantly higher degree in the ability of daily living activities than those with less educational level. The married women revealed significantly higher scores in physical activity, ADL, and IADL than the unmarried ones. The ability of daily living activities was not significantly related to having religion, economic status and living with family. 5. The average duration of experiencing osteoarthritis was 4 years and 7 months. Regarding the site of the onset, 65% of the subjects indicated knees. The women with osteoarthritis for less than 3 years were 65%. The ability of daily living activities was significantly different by the duration of illness : the longer the duration of illness, the less the ability of activities. The above findings suggest the need for developing those programs for prevention disabilities in performing daily living activities and for managing diseases targeting the women of middle and old age, with low educational level, and with unmarried status. In addition, there should be developed an instrument for measuring the ability of daily living activities which reflects daily lives of Korean women with osteoarthritis in order to examine comprehensive effects of osteoarthritis on women's daily lives in this country.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.31-45
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• 2000

Objectives : The present study was performed to reveal differences between female and male cases of alopecia in their alopecia related variables such as patterns of hair loss, psychiatric characteristics, associate illnesses, and methods of treatment, and to use them as basic materials for proper management and early prevention of the alopecia prone cases. Methods : In order to analysis the gender difference in hair losses, the subjects were divided into two subgroups as the 51 cases of female alopecia and the 42 cases of male alopecia, who had visited to the department of psychiatry consulted from the department of dermatology, Yongsan hopital, ChungAng University, Seoul, Korea, from January 1998 to December 1998. In data analysis, the subjects were statistically assesed by chi-squre test and analysis of varaiance, through SPSS-$PC^+$ 9.0V. Results : 1) Female subjects were more likely showed lower socio-economical level including lower eonomical level, lower educational level, or lower occupational level in their parent's job, were more likely to have larger number of siblings and to have many sisters comparison to the male cases. 2) Female subjects were more likely visited to the department of dermatology, more history of alopecia in their female family members, lesser history of alopecia in their male family members, more loss of hairs in vertex or frontal region of scalp, lesser loss of hairs in occipital region, and lesser nail changes in comparison to the male cases. 3) Female subjects were more suffered from intra-familial conflicts and economical changes, or their introverted personality makeup, lesser likely suffered from changes of business and health changes, and showed lesser conflicts related with poorer adaptaion in their job life. 4) Female subjects were more likely diagnosed as depression or conversion disorders, more frequently complaint anxiety symptoms or depressive symptoms, higher level of anxiety index, lesser complaint somatization or obsessive compulsive symptoms, and lesser diagnosed as anxiety disorder in comparison to the male cases. 5) Female subjects were more likely tended to show personality makeup such as the introverted, the lie, the repressed, or the feminine trends than the male cases. 6) Female subjects were more significantly treated by antianxiety drug such as etizolam and dermatological therapies include tretinoin, and lesser treated by clotiazepam and prednicarbonate in comparison to the male cases. Conclusion : From the facts that The most important factors in developing hair loss in the female subjects in comparison to the male cases seems to be closely correlated with the serious psychopathology such as the presence of mental disorders including depression, the presence of complaining anxiety or depressive symptomatology, the presence of stressful life events such as intrafamilial life changes, and the presence of personality makeup such as the introverted, the lie, the repressed, or the feminine trends, the authors confirmed that dermatologists act as the primary care physician are in a unique position to recognize psychiatric comorbidity and execute meaningful intervention for female patients with the alopecia with psychiatrists.

• Journal of dental hygiene science
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• v.5 no.2
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• pp.63-70
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• 2005

The relation among the variables of dental hygienists' both personal protection and infection prevention education was investigated in order to identify the necessity of realization of personal protection and utilize in the development of educational programs. The study tools included structured questionnaire and in-home interview. Data analysis included frequency and t-test, and the relations among the variables were as below: (1) Dental hygienist's maskwearing was most well observed in Kyonggi-do (90.0%) by locations, and in the dental hospitals (84.8%) by working places, which was statistically significant. (2) Glove-wearing was most well observed in the university and the higher graduates population (59.1%) by academic background, and in the dental hospital (73.9%) by working place, which was statistically significant. (3) Protection glasses-wearing was most well observed in Guns, Ups, and Myons (82.4%) by locations, which was statistically significant. (4) Uniforms were hand-laundered at home in the 40.9% of the university and the higher graduates, which was statistically significant. (5) About infection management, 67.0% of 2-year college graduates and 71.7% of the respondents from dental hospitals had been educated during their college days, which was statistically significant. (6) About the necessity of infection education, 77.3% of the university graduates responded it is very necessary, which was statistically significant.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.102-113
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• 2003

Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTI) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus (PIV), influenza virus(INF), adenovirus(ADV), etc. Our purpose of this study was to examine the seasonal occurrence, clinical and laboratory features of each viral infections. Methods : Nasopharyngeal aspirates(NPA) were collected from 913 hospitalized children on the first day of admission. They were all admitted to Hangang Sacred Heart hospital and diagnosed as LRTIs. The study period was from September 1998 to August 2002. Specimens were inoculated onto HEp-2 cell, LLC-MK2 cell and MDCK cell. Viruses were detected by immunofluorescent method performed at day 10 postinoculation. Respiratory viruses were detected in 251(27%) cases. Medical records of 208 cases diagnosed as acute LRTIs were all taken reviewed and analyzed. Results : The identified pathogens were RSV 122 cases(58%), PIV 30 cases(14%), INFA 20 cases(10%), INFB 21 cases(11%) and ADV 15 cases(7%) during the study period. Outbreaks of RSV infections occurred every year but mostly on December, 1998 and November, 1999. LRTIs by PIV and ADV occurred during all seasons of the year. INFA was isolated moslty on March, 1999 and January, 2000. INFB infections occurred largely on April, 2002. The clinical diagnoses were bronchiolitis 88 cases(43%), pneumonia 87 cases(42%), croup 19 cases(9%) and tracheobronchitis 14 cases(6%). Common symptoms and signs were cough, rhinorrhea, sputum and fever. WBC counts in peripheral blood showed normal findings in 123 cases(59%). Each viral infections also showed some differences in auscultatory findings and chest X-ray findings. Conclusion : We learned that viruses are one of the major and important etiologic agents of acute LRTIs of children in Korea. However, we still need to find out more about its characteristic clinical features and continue studying on their seasonal occurrence to focus on their management and also prevention.