• 대한간호학회지
• /
• 제26권4호
• /
• pp.808-819
• /
• 1996

The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권9호
• /
• pp.3595-3604
• /
• 2015

Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

• 지역사회간호학회지
• /
• 제13권4호
• /
• pp.743-756
• /
• 2002

Purpose: This study is a descriptive and comparative study that compares health state and school adaptation between children in divorced family and in normal family. Study results will provide a basic data for the development of an intervention program designed to help children in divorced family adjust to their crisis. Method: The study subjects consisted of 700 children in 4th. 5th or 6th elementary school grade, residing Seoul and Kyunggi regions. Among these subjects, 123 were children with divorced family and 577 were children with normal family. The health status of the subjects was measured by Health Symptom Questionnaire developed by Shin and revised by the investigators. The instrument consisted of 30 items measuring physical and emotional health symptoms. The level of school adaptation of the subjects was measured by School Adaptation Scale developed by Lee, which consisted of 4 dimensions with 20 items what measures relationship with peer students, learning activity, observance of regulation, and participation of school activity. The investigators visited the schools and collected data in the classes using the questionnaire after explaining the purpose and procedures of the study to the children. The data were analyzed by descriptive statistics, $\yen\"{o}2$-test, t-test, ANOVA using the SPSS PC + statistical program. Result: First, the mean health state score in children with normal family (M=11.99) was higher than that in children with divorced family (M=19.15), showing a significant difference (t=-6.51, p=.000) between the two groups, which suggests that children with normal family have better health state than children with divorced family. Second, the mean school adaptation score in children with normal family (M=38.99) was higher than that in children with divorced family (M=26.97), showing a significant difference between the two groups (t=104.07, p=.000), which suggests that the school adaptation of children with normal family is better than that of children with divorced family. Third, in comparison of health state between the two groups by general characteristics. there were significant differences between the two groups in sex. the most contributing factor to health status of the children, school year. birth order, religion, school achievement, amount of monthly pocket money, parents level of formal education, occupation of parents, economic status (p<.05). Forth, in comparison of the level of school adaptation between the two groups by general characteristics, there were significant differences between the two groups in most variables (p<.05), suggesting that children with normal family had better capacity of school adaptation than children with divorced family. Conclusion: As a result. this study showed that the parent's divorce had great influence on children's health status and school adaptation capacity. The implication for nursing is that there is a need to develop supportive interventions for the high-risk children who have decreased health states and school adaptation capacity due to the divorce of their parents. In addition, it is recommended that further studies should be conducted to explore protective factors for the prevention of health and adaptation problems in children.

• Journal of Preventive Medicine and Public Health
• /
• 제37권4호
• /
• pp.381-389
• /
• 2004

Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

• 대한지역사회영양학회지
• /
• 제13권2호
• /
• pp.263-275
• /
• 2008

Impaired fasting glucose (IFG) is one of significant risk factors of developing diabetes. The persons with IFG are, thus, an important target group for primary prevention of diabetes. It is well known that plasma homocysteine concentration may be increased in poor folate nutritional status. Elevated level of plasma homocysteine is considered as a marker of enhanced oxidative stress. In addition, the protective effect against oxidative stress may be diminished in poor antioxidative nutrient status as vitamin C. It is, therefore, important to maintain adequate nutritional status of folate and vitamin C in the patients with type 2 diabetes or IFG. This study was performed to determine the effects of supplementation of folic acid or vitamin C on plasma concentrations of homocysteine, oxidized LDL, and lipids and on the activity of plasma anti-oxidative enzyme in patients with IFG. A total of 97 patients with IFG were participated voluntarily with written consents. They were divided into one of the four experimental groups; Control (C), Folatesupplemented (F), Ascorbate-supplemented (A), and Folate plus ascorbate-supplemented (FA). The subjects in C were taken placebo, those in F were supplemented 1 mg of folate, those in A were received 1,000 mg of vitamin C, and those in FA were given 1 mg of folate plus 1,000 mg of vitamin C daily for 4 weeks. No change in plasma concentrations of vitamin C, lipids, and oxidized LDL and the activity of GSH-Px were observed in vitamin C-supplemented group (A + FA) and folate-supplemented group (F + FA) compared to the placebo group (C + A). Only the folate-supplemented group (F + FA) had significantly increased average serum folate concentration and lowered plasma homocysteine concentration compared to the placebo group (C + A). Thus, it should be recommended the patients with IFG to increase folate intake through diets and, if it is not sufficient, to take folic acid supplements to prevent the development of complications induced by hyperhomocysteinemia as well as oxidative stress.

• 한국심리학회지 : 문화 및 사회문제
• /
• 제21권4호
• /
• pp.671-696
• /
• 2015

본 연구에서는 세월호 침몰사고 직후와 이후 두 달 뒤 수집한 노년기 정서 경험 자료를 바탕으로, 노인들이 재난 간접 경험 이후 경험하는 정서의 변화에 영향을 주는 개인차 변인들의 효과에 대해 살펴보았다. 본 연구에서는 정서 경험에 대한 보호요인 및 위험요인으로 작용하는 사회적 지지와 우울 수준의 영향과 더불어, 미래시간조망과 활동적 노년이 건강한 삶을 예측한다는 기존 연구를 바탕으로, 두 변인이 정서 변화 양상에 미치는 영향도 함께 살펴보았다. 연구 결과, 세월호 사건 직후와 이후를 비교했을 때 사고 직후 예상대로 전반적으로 긍정적 정서가 감소하였고 부정적 정서는 상승하였다. 또한 사회적 지지, 미래시간조망, 및 활동적 노년 점수가 높은 사람들과 우울 점수가 낮은 사람들은 두 시점간의 정서 변동의 폭이 크지 않았지만, 반대의 사람들은 사건 직후 상대적으로 낮은 수준의 긍정적 정서와 높은 수준의 부정적 정서를 경험하였다. 본 연구를 통해 사회적 지지, 미래시간조망, 활동적 노년 개념이 노년기 정서에 보호요인으로, 우울은 위험요인으로 작용한다는 점을 확인할 수 있었으며, 구체적으로 어떠한 정서에 영향을 주는지도 함께 확인할 수 있었다. 마지막으로, 본 연구의 의의와 한계에 대한 논의를 통해 후속 연구에 대한 방향을 제안하였다.

• 한국사회복지학
• /
• 제51권
• /
• pp.311-327
• /
• 2002

본 연구는 장애아동은 비장애아동과 비교할 때 학대의 위험에 노출될 가능성이 높다는 기존의 연구결과에 근거하여 장애아동부모의 양육스트레스와 학대유발가능성과의 관계를 조사하였다. 서울, 경기, 강원지역에 거주하는 13세 미만의 장애자녀를 둔 150명의 장애아동 부모들이 조사에 참여하였으며, 조사도구는 부모의 양육스트레스정도와 학대행위에 대한 정당성을 묻는 문항들로 구성되었다. 연구결과에 의하면, 장애아동 부모들은 자녀의 장애로 인해 비교적 심한 양육스트레스를 경험하고 있으며, 양육스트레스를 느끼는 정도에 따라 아동학대 행위에 대해서도 태도의 차이를 보이고 있는 것으로 나타났다. 또한, 부모의 양육스트레스와 학대행위에 대한 태도와 관련하여 부모의 학력, 수입, 사회활동여부, 정부의 지원여부, 장애인복지서비스 이용여부는 서로 상관관계가 있는 것으로 나타나고 있다. 특히, 단계식 다중회귀분석(stepwise multiple regression)을 통해 장애인복지서비스 이용여부와 부모의 사회활동여부는 장애아동 부모의 양육스트레스와 학대행위에 매우 중요한 영향을 미치는 요인으로 나타남으로써 장애아동 부모들을 위한 구체적이고 다양한 지원의 필요성을 제기하고 있다. 본 연구의 결과는 장애아동 부모의 양육스트레스와 아동학대와의 관련 가능성을 제시하고 있다고 보여지며, 부모의 양육스트레스가 아동학대의 주요 원인이 될 수 있다는 기존의 연구들을 종합해 볼 때 앞으로 장애아동부모의 양육스트레스 감소를 위한 적극적인 사회적 개입이 절실하다고 보여진다.

• 정신신체의학
• /
• 제26권2호
• /
• pp.94-101
• /
• 2018

연구목적 본 연구는 완화병동에 입원한 환자들에서 사망 직전에 발생하는 임종기 섬망의 발생을 사망 전 2주시점 전부터 관찰하여 변화양상과 선행 요인을 관찰한 연구이다. 방 법 2015년 10월부터 2017년 8월까지, 일 대학병원 완화병동에 입원한 말기 암환자 최종 180명을 대상으로 후향적 연구를 진행하였다. 대상자는 매일 3회 Richmond Agitation Sedation Scale과 Nursing Delirium Screening Scale로써 섬망의 세가지 아형으로 진단되었다. 결 과 임종 13일 전 섬망의 빈도는 46%였으며, 그 중 18.3%는 과활동성, 13.8%는 저활동성 그리고 혼합성 아형은 13.8%를 차지하였다. 과활동성 섬망은 임종일까지 점차 감소하는 양상이었으며, 저활동성 아형과 혼합성 아형의 섬망은 임종 4일 전까지 점차 증가하는 양상이었다. 임종 하루 전 86.9%의 환자들은 섬망으로 진단되었다. 다변량 분석에서 위장관 암보다 혈액학적 암이 낮은 임종기 섬망과 연관이 있었으며 과체중도 낮은 임종기 섬망과 연관이 있었다. 결 론 많은 완화의료 환자들은 섬망을 경험하였으며, 과체중은 임종기의 모든 아형의 섬망을 낮추는 보호인자로 고려되었다. 차후 임종기 섬망의 빈도와 위험 인자를 밝히는 전향적 연구가 필요할 것이다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권10호
• /
• pp.5299-5302
• /
• 2012

Purpose: To investigate the diet of patients with cervical cancer and precancerosis in the Wufeng area, a high-incidence region in China. Methods: In the case group, 104 patients diagnosed with cervical cancer or cervical intraepithelial neoplasias (CINII/III) were recruited from the Wufeng area. Nine hundred thirty-six healthy women were selected from the same area as the matched controls. A questionnaire, which included questions about general lifestyle conditions, smoking and alcohol status, source of drinking water, green tea intake, and diet in the past year, was presented to all participants. Results: Green tea intake (P=0.022, OR=0.551, 95% CI=0.330-0.919) and vegetable intake (P=0.035, OR=0.896, 95% CI=0.809-0.993) were identified as protective factors against cervical cancer or CINII/III. There was no indication of any associations of other lifestyle factors (smoking status, alcohol status, source of drinking water) or diet (intake of fruit, meat/egg/milk, soybean food, onion/garlic, staple food and pickled food) with cervical cancer. Conclusions: The results suggest that eating more fresh vegetables and drinking more green tea may help to reduce the risk of cervical cancer or CINII/III in people of the Wufeng area.

• 대한영상의학회지
• /
• 제85권3호
• /
• pp.566-578
• /
• 2024

목적 전산화단층촬영(이하 CT) 유도 경피 폐 생검에서 흉막 천자 시에 호흡 시기가 합병증 발생에 영향을 미치는지 조사하는 것이다. 대상과 방법 자유 호흡 중 시행된 폐 생검의 CT 스캔 477개를 후향적으로 검토하였다. 흉막 천자 시 호흡 시기는 자유 호흡 중 얻은 CT 영상에서 목표 결절의 table position의 차이로 분석 평가하였다. 세 가지 호흡 시기(흡기, 중간, 호기)에서의 합병증 발생률을 비교하였다. 기흉에 대한 교란변수를 통제하기 위해 로지스틱 회귀 분석을 하였다. 결과 477건의 시술 중에서 흉막 천자는 227건(47.6%)에서 호기, 108건(22.6%)에서 중기, 142건(29.8%)에서 흡기에서 시행되었다. 기흉 발생률은 호기에서 유의하게 낮았고(40/227, 17.6%; p = 0.035) 중기에서 유의하게 높았다(31/108, 28.7%; p = 0.048). 교란변수를 통제한 후, 호기 시 흉막 천자는 기흉에 대해 독립적인 보호 요인으로 작용하였다(오즈비 = 0.571; 95% 신뢰구간 = 0.360-0.906; p = 0.017). 결론 본 연구 결과는 이미지 유도하 경피적 폐 생검시 호기에서 흉막 천자를 시행하는 것이 기흉 발생률을 감소시킬 수 있음을 보여주었다.