• Title/Summary/Keyword: patients' determinants

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Potential Predictors of Sensitivity to Pemetrexed as First-line Chemotherapy for Patients with Advanced Non-Squamous NSCLCs

  • Lu, Yan-Yan;Huang, Xin-En;Xu, Lin;Liu, De-Gan;Cao, Jie;Wu, Xue-Yan;Liu, Jin;Xiang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2005-2008
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    • 2013
  • Background: Pemetrexed (PEM) is effective in first-line treatment for patients with non-squamous non-small cell lung cancer (NSCLC). However there are currently no definitive determinants to certify which patients could benefit from PEM. To improve the efficacy of PEM combined with platinum as first-line therapy for advanced non-squamous NSCLC, we conducted this retrospective study to detect potential determinants of this regimen. Methods: We recruited 109 patients with advanced non-squamous NSCLC who received PEM with a platinum as first-line therapy from June 2006 to February 2013 in Jiangsu Cancer Hospital. Multiple variables (age, sex, smoking, degree of cell differentiation, hemoglobin, platinum drugs combined, positions of metastasis) were selected. Logistic regression analysis was used to analyse relationships between these variables and tumor response. Result: In univariate analysis, we found that age and platinum significantly influenced the results of PEM therapy (P<0.05). In multivariable analysis, no factors were independently significant. Conclusion: Our analysis did not suggest that the age, sex, metastasis of liver or other organs, hemoglobin, smoking history and pathological differentiation are associated with the response of PEM. We should conduct further analyses with larger sample size to reconfirm this issue.

The Subjective Burden of Family Caregivers with Schizophrenics and Its Predictors (정신분열병 환자 가족보호자의 주관적 부담과 그 결정요소)

  • Choi, Hae-Kyung
    • Korean Journal of Social Welfare
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    • v.45
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    • pp.374-399
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    • 2001
  • Experiences of the subjective burden and its determinants were analyzed in a sample of 110 primary family caregivers of adult schizophrenic patients. The subjects reported varying amount of subjective burden and its mean score was 17.84 that meant considerably high level of subjective burden. Reports of subjective burden were high in the items of 'pity', 'frustration and resentment', 'regret'. The result of factor analysis revealed that subjective burden consisted of four factors such as 'hopelessness', 'frustration and resentment', 'fear', and 'pity and anxiety'. The results about the determining variables of subjective burden indicated that the prognosis of patient, perceived stigma, the number of previous hospitalization, the availability of secondary caregiver, primary caregiver's age, and family income were predictive of primary caregivers' subjective burden. The result examining the multivariate relationship among subjective burden, stressors, social support, family demographic and socioeconomic characteristics revealed that the more important determinants of subjective burden were the prognosis of patient, perceived stigma, and the number of previous hospitalization, Implications for intervention to help with primary caregivers' subjective burden were discussed.

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The Influencing Factors of the Compliance Level with Therapeutic Regimen after the Bone Mineral Densitometry (골밀도 검사 후 치료지시 이행정도에 영향을 미치는 요인)

  • 유영원;이은남
    • Journal of Korean Academy of Nursing
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    • v.34 no.1
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    • pp.63-71
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    • 2004
  • Purpose: This study was to identify the influencing factors of the compliance level to a therapeutic regimen after a bone mineral densitometry test. Method: The sample for the study was 95 people who took the bone mineral densitometry test from March, 2002 to July, 2002. Data was collected by mail using aself reporting questionnaire on the selected variables such as the compliance level, self efficacy, health locus of control, susceptibility, severity, usefulness, barrier, and self esteem. Results: The average compliance level was 63.93. Through multiple regression, three independent variables including chance health locus of control on personality, the result of bone mineral density and self-efficacy were entered in the model as the significant determinants of the compliance level after a bone mineral densitometry test. The coefficients of determination of each variable were 10.9%, 8.3% and 8.1% respectively. Conclusion: The identification of the determinants of the compliance level to the therapeutic regimen after bone mineral densitometry is expected to contribute to the development of an intervention program to improve the compliance level to the therapeutic regimen in osteoporosis patients.

An Explanatory Model for Health-Promoting Behaviors in Patients Living at Home who have Post Stroke Hemiplegia (재가 편마비 환자의 건강증진행위 설명모형)

  • Kim, Mi-Hee
    • Journal of Korean Academy of Nursing
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    • v.36 no.6
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    • pp.1065-1075
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    • 2006
  • Purpose: A structural equation model was analyzed to explore the determinants of health-promoting behaviors in patients living at home in Korea who had post stroke hemiplegia. Method: Demographic characteristics, activities of daily living, religiosity, family support, self-efficacy, acceptance of disability, perceived barriers to health-promoting activities, depression, and health-promoting behavioral data was collected from 239 patients using self-report questionnaires. Result: Variables that have a direct effect on health-promoting behaviors were self-efficacy and family support. Depression, acceptance of disability, perceived barriers, activities of daily living and religiosity also influenced health-promoting behaviors in an indirect way. Conclusion: It is imperative to explore strategies for patients with post stroke hemiplegia to identify and maximize their resources, develop their self-efficacy, improve their emotional state, and enhance their physical activity and spiritual growth, which would maximize health-promoting behaviors.

Evaluation of drug interventions for the treatment of sleep disorders in children with autism spectrum disorders: a systematic review

  • Jenabi, Ensiyeh;Ataei, Sara;Bashirian, Saeid
    • Clinical and Experimental Pediatrics
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    • v.62 no.11
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    • pp.405-409
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    • 2019
  • A structured review study of drug interventions on sleep disorders in patients with autism spectrum disorders (ASD) has not been published to date. This systematic review aimed to investigate drug interventions for the treatment of sleep disorders in children with ASD. The Web of Science, PubMed, and Scopus databases were searched until March 2019. Study quality was assessed using the Delphi checklist. Due to the heterogeneity of the findings, a meta-analysis was not possible. Drug interventions for the treatment of sleep disorders in patients with ASD included melatonin, atomoxetine, and risperidone. Atomoxetine had no effect on sleep disorders in patients with ASD. A total of 10 studies were reviewed. Melatonin appears to be useful for the treatment of sleep problems in patients with ASD, but further studies are needed to determine the effects of other drugs.

Determinants affecting patients loyalty in medical service: An empirical study on comparison with in-patients and out-patients using multi-group structural equation model (대학병원환자의 의료서비스 충성도에 영향을 미치는 요인에 관한 연구: 멀티그룹 공분산구조분석을 이용한 입원환자와 외래환자의 인식차이 비교분석)

  • Lee, Sang-Chul;Kim, Yang-Kyun;Chang, Sung-Gu;Han, Sang-Suk
    • Korea Journal of Hospital Management
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    • v.13 no.4
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    • pp.76-100
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    • 2008
  • The purpose of this research is to identify causalities among service quality, service value, customer satisfaction and customer loyalty and to compare the causalities between in-patients and out-patients. A multi-group structural equation model was used to test the hypothesis of conceptual model. Empirical results indicate that two factors such as assurance and empathy have direct impact on service value and customer satisfaction in both the patients. In the results of multi-group comparison test, however, the path coefficients from service value to customer loyalty and from customer satisfaction to customer loyalty were different across the two groups. In out-patients, customer loyalty is more positively related with service value. In in-patients, customer loyalty is more positively related with customer satisfaction. It is proven that service quality influences customer loyalty. Therefore To compete successfully in today's volatile & competitive medical markets, the hospital needs to manage the service quality, considering the type of patients.

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Estimating the Economic Burden of Lung Cancer in Iran

  • Rezaei, Satar;Sari, Ali Akbari;Woldemichael, Abraha;Soofi, Moslem;Kazemi, Ali;Matin, Behzad Karami
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4729-4733
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    • 2016
  • Objectives: Lung cancer is a major public health problem and one of the most costly illnesses. The study aimed to estimate the economic burden of lung cancer in Iran in 2014. Methods: A cross-sectional study was conducted to estimate the direct and indirect costs for patients with lung cancer using a prevalence-based approach. A human capital approach was employed to estimate the indirect costs. Data were obtained from several sources such as through patient interview using structured questionnaire, medical records, the GLOBOCAN databases, the Iranian Statistical Center, the Iranian Ministry of Cooperation, Labor and Social Welfare, and the Institute for Health Metrics and Evaluation (IHME). Results: The economic burden of lung cancer in Iran in the year 2014 was 3,225,998,555,090 IR. The main components of the cost were associated with mortality (81.9 %) and hospitalization (7.6 %). The costs of direct medical care, non-medical aspects, patient time, and mortality accounted for 10.8%, 2.7%, 4.5%, and 81.5% of the total cost, respectively. Conclusion: Findings from this study indicated that the economic burden of lung cancer is substantial both to Iran's health system and to society as a whole. Early diagnosis, strengthening cancer prevention, implementing new cancer therapy and medical technology, and effective smoking-cessation interventions could offset some of the costs associated with lung cancer in Iran.

A Panel Study on the Determinants of the Regional Variation in the Rate of Certification in Long-Term Care Insurance (노인장기요양보험 지역별 인정률 결정요인에 대한 패널분석)

  • Sakong, Jin;Song, Hyunjong
    • Health Policy and Management
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    • v.27 no.1
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    • pp.56-62
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    • 2017
  • Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients

  • Lee, Yeon Joo;Oh, Il Hwan;Baek, Hee Jun;Lee, Chang Hwa;Lee, Sang Sun
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.158-164
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    • 2015
  • BACKGROUND/OBJECTIVES: Vitamin D deficiency is common in hemodialysis patients. The aim of this study was to identify whether or not sun exposure and dietary vitamin D intake have effects on serum 25-hydroxyvitamin D (25(OH)D) status in hemodialysis (HD) patients. The objective was to identify the main determinants of serum vitamin D status in the study subjects. SUBJECTS/METHODS: A cross-sectional study of 47 HD patients (19 males and 28 females) was performed. We assessed serum 25(OH)D and $1,25(OH)_2D$ levels between August and September 2012 and analyzed the prevalence of vitamin D deficiency in HD patients. To evaluate the determinants of serum 25(OH)D levels, we surveyed dietary vitamin D intake, degree of sun exposure, and outdoor activities. To compare biological variables, serum 25(OH)D was stratified as below 15 ng/ml or above 15 ng/ml. RESULTS: Mean 25(OH)D and $1,25(OH)_2D$ levels were $13.5{\pm}5.8ng/ml$ and $20.6{\pm}11.8pg/ml$, respectively. The proportions of serum 25(OH)D deficiency (< 15 ng/ml), insufficiency (15-< 30 ng/ml), and sufficiency (${\geq}30ng/ml$) in subjects were 72.4%, 23.4%, and 4.3%, respectively. Prevalence of vitamin D deficiency in female patients was 78.6%, whereas that in males was 63.2% (P = 0.046). Vitamin D intake and sun exposure time were not significantly different between the two stratified serum 25(OH)D levels. Dietary intake of vitamin D did not contribute to increased serum 25(OH)D levels in HD patients. The main effective factors affecting serum 25(OH)D status were found to be the sun exposure and active outdoor exercise. CONCLUSIONS: Hypovitaminosis D is common in HD patients and is higher in females than in males. Sun exposure is the most important determinant of serum 25(OH)D status in HD patients.

Treatment Process and Outcomes of Brain Injuried ER Patients (응급실 내원 뇌 손상 환자의 진료과정과 결과)

  • Hong, Hye-Ryeon;Jin, Ki-Nam;Lee, Dong-Woo;Kim, Jae-Su
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.481-489
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    • 1998
  • Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.

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