• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1183-1192
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• 2006

Purpose: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. Method: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. Results: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were ilot confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. Conclusion: The results support the strong need for development of a multi-component educational program on delirium care.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.3-33
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• 1971

Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.281-299
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• 1990

The organization of nursing department Significantly effects the hospital management. Especially, The head nurse is one of the most important position because head nurse is a first-line manager in the hospital level, a middle manager in nursing service organizations level and the top manager in each nursing unit level. This study was attempted to show the ideal model and nile by compare head nurses' role perception with staff nurses' role expectation according to two types of hospital. The survey was conducted among 94 head nurses and 233 staff nurses who are working at 5 different University Hospitals over 600 beds and 93 head nurses and 218 staff nurses Who are working at 12 different General Hospitals between 100∼300 beds in Seoul. The data was collected in a period from 8th September to 13th October in 1989 and the instrument used for this study was based on Han's one and reffered back to many literary sources and revised. The collected data was analysed by computer using S.P.S.S. program as a Mean, Percentage, Cronbach's alpha, Chi-Square, t-test and ANOVA. 1. The study was compared to the difference of the two subject group's general characteristics according to a type of hospital. As a relult, there were significant differences in age, educational background and career. 2. This Study was compared to the difference of the two subject group's role perception and role expection about each question according to a type of hospital. The result of this comparisons as follows : First, These were the most important issue between both groups : “Head nurse has to know about her staff's events and problems and then help them to solve that promptly.” Second, These were the least important issue between both groups : “Head nurse has an interview with patient's family and visitors”, “Head nurse is interested in her staff's privacy.” 3. This study was compared to the differences of each role areas according to a type of hospital. As a result, there were no significant differences both two subject groups except nursing manager role in staff nurses' group(t＝-2.893, df＝449.0, p＝0.004). 4. This study was tested to the difference of the two subject groups according to general characteristics. As a result, All of that there were no significant differences.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.247-275
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• 1998

The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

• Child Health Nursing Research
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• v.4 no.2
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• pp.274-285
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• 1998

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.

• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Journal of the Korean Society of Food Culture
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• v.37 no.2
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• pp.143-152
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• 2022

Galactosemia is a rare genetic metabolic disease caused by galactose and its metabolites generated during carbohydrate metabolism, which is relatively rare in Asian countries, including Korea. Patients with galactosemia should be treated with a galactose-restricted diet. However, information is lacking about the exact content of galactose in food, and dietary guidelines for patients with galactosemia in Korea. This study aims to recognize the difficulties faced by parents and clinical experts of patients with galactosemia, and understand their demands. Totally, 5 parents of children diagnosed with galactosemia and 5 clinical professionals participated in the focus group interviews. The parents' interview focused on the daily life of the patient, which included diet and social difficulties. The clinical experts mainly answered about medical care, including the number and status of patients, and their suggestions for effective treatment. Most parents were worried about social isolation due to conflicts in the family as well as in society due to a lack of understanding of the disease. The clinical experts stated the absence of a disease management system as the greatest problem. An integrated support system for patients with galactosemia, which includes appropriate dietary guidelines by considering the domestic environment, is required.

• The Korean Nurse
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• v.34 no.1
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• pp.60-73
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• 1995

We carried out this study for recognizing the staue of child inpatient nursing and providing child inpatient with better qualified nursing. We study this research from March 29, 93 to April 23, 93 to April 23, '93. First admission day in hospital, we ask 50 mothers of hospitalized child inpatient about the value of nursing and self-consciousness of mothers, also ask 10 nurse in charge about the satisfaction of tending child inpatient Two times-third admission day in hospital and leaving day, we inquired mothers the value of nursing of mothers by inquiry papers, each measurement was made up of five indexes. The result of research was as follow: 1. The subjects of research had following peculiarities. Average age : 2.5 years 0~ 1 years : 32.0% Baby girl : 56.0% first baby : 58.0% Experienced inpatient : 52.0% The number of hospitalization times was 1~2 times : 61. 5% The average period of hospitalization : 7 days Infected inpatient with respiratory organ disease : 40.0% The mother's average age of child inpatient : 30.5 years Mother's who finished high school : 90.9% Family that income about 600,000-700,000 won : 32.0% Mothers who belived an religion : 50.0% 2. As hospitalization time goes by, mothers gradually failed to recognize the value of nursing. 3. Self-estimated tending satisfactions have no connection with the value of nursing that mothers recognized. 4. The value of nursing was effected by mothers own personnality-salf-consciousness care, experience of hospitalization, academic background & religoin. So, we find out that the value of nursing had no connection with satisfaction of tending. Nurses must make every effort to provide child inpatient with nursing of good quality, that mothers confirm and nurses satisfy themselves. Also, we have to emphasize the importance of home and school education, because these education have a great influence upon mother s self-consciousness.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.1
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• pp.1-10
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• 2017

Purpose: This study aimed to investigate the perception and emotional experiences in rare and intractable diseases for caregivers of pediatric patients with mitochondrial diseases in order to provide therapeutic interventions for patients, caregivers, and families. Methods: A total of 83 caregivers of pediatric patients with mitochondrial diseases were recruited from the pediatric mitochondrial disease clinics of the Gangnam Severance Hospital in South Korea. Participants completed the survey about their perception of mitochondrial disease and emotional experiences after the diagnosis, and these clinical data were analyzed accordingly. Results: Surveys from a total of 83 caregivers of patients were analyzed, and the patients' age ranged from 6 to 12 years (33%), followed by ages 1 to 6 years (30%). Children with mitochondrial diseases were between 0 and 0.5 years of age at the time of first symptom onset (43%), and the duration of illness lasted more than 10 years in most cases (42%). Prior to diagnosis of mitochondrial diseases, the amount of awareness the caregivers had was 'Not at all' for both rare and intractable diseases and mitochondrial diseases in 44 cases and 68 cases, respectively. For the caregivers' emotional experiences, the most common initial responses were 'Discouraged/despair', 'Helpless/lethargic', and 'Disconcerted'. 'Anxious', 'Committed to treatment', and 'Responsibility as family members' were the most common emotional responses from the caregivers, followed by 'Disconcerted' and 'Helpless/lethargic'. Conclusion: It is important to consider the level of perception and emotional experiences of caregivers and patients with rare and intractable mitochondrial diseases for planning treatment programs.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.39-52
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• 1995

Burning mouth syndrome is characterized by a burning sensation in oral cavity without clinical signs. There has b een no established theories about the diagnosis and treatment. The purpose of this article is to examine the clinical feature of BMS patients of Korean and to present a treatment protocol that can be helpful in clinical applications. The subjects chosen for the study were 52 patients who had visited Department of Oral Diagnosis at Yonsei University Dental Hospital and were diagnosed as BMS. We did questionnaires and precise oral exam, laboratory exam, grouping of our patients, individual treatment for the groups and classification of responses to the treatment. The following results were obtained: 1. Chief complaints were throbbing (71.2%), pricking, stinging, tingling (30.8%), burning(25a%). The tongue is the most frequently affected site (82.7%), followed by full mouth, gingiva, palate, buccal mucosa, lips, throat, labial mucosa and floor of mouth. 2. The average age of onset was 48.1 year and the male to female ratio was 1 to 3. The average duration of symptom was 11.69 months for male and 23.07 months for female. 3. 32.7% of patients had appealed continuous pain, which was the most cases. Aggravating factors were peppery food, salty food, hot food, fatigue, tension conversation, sour food, cold food and toothpaste. Reducing factors were cold food, diet, going to sleep and smoking. 4. Associated symptoms were dry mouth, other life problem, altered taste perception, bad taste, throat pain, tingle and difficulty in swallowing. 5. Most of patients had appealed that there was not associated event on onset of symptom, and the order of prevalence is as fallow; dental treatment, stress, denture wearing, an attack of a systemic disease. 92.3% of patient appealed that there was no psychological withering and 7.7% of patients appealed positively. 6. There were eight males and four females that had jobs. 7. There was no family history in 100% of patients in questions about presence of family history. 8. 96.2% of patients appealed that there was no oral habits. 13.5% of patients had dryness of oral mucosa in oral exam. A significant relation to dental prosthesis was not observable, but incidence of diseases due to stress appeared high in BMS which had the clinical characteristics as above. A group having low serum iron was 63.5% and in this group period of potential iron deficiency appeared high in incidence just before move to anemia. A group represented positive response was 38.5% in fungus study for Candida albicans. Since we can expect high treatment response by prescription of iron-contained drug and antifungal drug in these patients, diagnosing patients' condition of BMS can be achieved in more various aspects through study for serum iron and Candida albicans. Furthermore, it is expected that treatment protocol can be made.