• Title/Summary/Keyword: psychosocial function

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Development of Health Promotion Program for Individuals With Arthritis -Application of Holistic Model- (관절염 환자를 위한 건강증진 프로그램의 개발 -총체적 모델의 적용-)

  • 오현수;김영란
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.314-327
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    • 1999
  • In this study, domains, contents, and effects of pre-existed intervention programs for individuals with arthritis were meta-analyzed to develop arthritis health promotion program based on Holistic Model. The developed program includes strategies of cognition, environment, and behavior. and also generates positive changes in the physical, psychological, and social demensions. Then needs assessment on conveniently selected 153 women who visited a university hospital in Seoul or in Inchon are conducted to identify the objective domains of arthritis health promotion program According to the study results. target health problems of the arthritis health promotion program were shown as pain, disability, depression, and role impediment in social domain. These objectives could be achieved by including the strategies of changing cognition, the strategies of changing behavior through learning the skill related to the health promoting behavior. and the strategies of changing environment in the health promotion program. That is, it is analyzed that the contents of program are not exclusive one another in physical. psychological. and social demensions, and also are not exclusive one another in aspect of cognition, behavior, and environment. The necessary methods to achieve the desired objectives for the developed arthritis health promotion program and evaluation subjects are as follows : (1) In the arthritis health promotion program, knowledge on management of arthritis, efficacy related to arthritis management, skill for pain management, skill for exercise, establishment of positive self-concept, enhancement of positive thinking, stress management. skill for problem solving, skill for setting goals. skill for requesting help, and skill for communication are all included. Through the improvement of all those strategies, intermediate objectives, such as “joint protection, and maintenance of pain management behavior”, “maintenance of regular exercise”, and “promotion of coping skill in psychosocial dimension” are achieved. (2) These intermediate objectives are also the methods for achieving objectives in next stage. It implies that through the intermediate objectives. the final objectives such as “minimization of physical symptoms and signs”, “maximization of psychological function”, and “maximazation of role performance in social domain” could be achieved. Each of these final objectives reflects the different dimension of quality of life, respectively. When these objectives are achieved, the quality of life that client perceives is improved. Therefore, through evaluation of these final objectives, the level of achieving final outcome of arthritis health promotion such as quality of life is determined.

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A cross-sectional study of the association between mobile phone use and symptoms of ill health

  • Cho, Yong Min;Lim, Hee Jin;Jang, Hoon;Kim, Kyunghee;Choi, Jae Wook;Shin, Chol;Lee, Seung Ku;Kwon, Jong Hwa;Kim, Nam
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.22.1-22.7
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    • 2016
  • Objectives This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. Methods This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. Results The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Conclusions Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.

Evaluation of Pregnancy and Thyroid Function (임신과 갑상선 기능의 평가)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.1
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    • pp.1-10
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    • 2018
  • During early pregnancy, before the development of a functioning thyroid gland, thyroid stimulating hormone (TSH) is a very sensitive marker of thyroid dysfunction during pregnancy. Normal values have been modified during gestation with a downward shift. The fetus is influenced by the TSH supplied by the mother. TSH and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. A downward shift of the TSH reference range occurs during pregnancy, with a decrease in both the lower and upper limits of maternal TSH, relative to the typical non-pregnant TSH reference range. Each laboratory produces its own reference TSH and FT4 concentrations because there are many different assays that yield different results in pregnancy. Therefore, automated immunoassays used for serum FT4 analysis are still used widely, but the important considerations discussed above must be noted. The use of population-based, trimester-specific reference ranges remains the best way to handle this issue The slight downward shift in the upper reference range of TSH occurring in the latter first trimester (7~12 weeks) of pregnancy, typically not observed prior to 7 weeks. Their use indicates high or low levels in a quantitative manner independent of the reference ranges. These data highlight the importance of calculating population-based pregnancy-specific thyroid parameter reference intervals. A precision medicine initiative in this area will require the collection and analysis of a large number of genetic, biological, psychosocial, and environmental variables in large cohorts of individuals. Large prospective randomized controlled trials will be needed to resolve these controversies.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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A Study for Dose-Reduction of Antipsychotics in Chronic Schizophrenics (만성 정신분열병 환자에서 항정신병약물 감량에 관한 연구)

  • Hwang, Tae-Yeon;Lee, Min Soo;Kim, Hyeong-Seob
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.263-277
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    • 1998
  • Conventional high-dose antipsychotics tend to result in more side effects, negative symptoms and dysphoria, and at the same time lower the cognitive function which is already impaired in most schizophrenics. Florid psychotic symptoms, negative symptoms and cognitive impairment greatly impede psychosocial performance and eventual reintegration into society. The reduction of symptom and the improvement of cognitive funtions and social skills are therefore central to the psychiatric rehabilitation process. The purpose of this study was to evaluate the dose-reduction effects of antipsychotics on chronic schizophrenics prescribed conventional high-dose antipsychotics more than 1,500mg equivalent of chlorpromazine. Fifty-one chronic schizophrenics who maintained high-dose antipsychotics for more than three months were randomly assigned to two groups : 20 patients comprised the dose-maintaining group and 31 patients made the dose-reduction group. Over a sixteen weekperiod Positive and Negative Syndrome Scale(PANSS), Extrapyramidal Symptom(EPS), Nurses' Observation Scale for Inpatient Evaluation(NOSIE-30), Continuous Performance Test(CPT), Quality of Life(QOL), and haloperidol/reduced haloperidol blood levels were determined at the base line and after 2, 4, 6, 8, 12, 16 weeks to evaluate the dose reduction effects of high-dose antipsychotics. The results were as follows : 1) Dose-reduction is highly effective in reducing positive and negative symptoms, and general psychopathology. Effects were most prominent at 8, 12, 16 weeks. Among the dose reduction group, positive symptoms in positive symptom group and negative symptoms in negative symptom group were more reduced. 2 Extrapyramidal symptoms showed no significant difference between two groups. But the EPS was reduced time after time within two groups. 3) Hit rates of Continuous Performance Test, which indicate attentional capacity, increased significantly after dose reduction. 4) Haloperidol and reduced haloperidol blood levels decreased until the 4th week, after which they were constant. 5) Total scores of Nurses' Observation Scale for Inpatient Evaluation were unchanged between the two groups. But among the indices, social interest and personal neatness were improved in the dose-reduction group and retardation was aggrevated in the dose-maintaining group. 6) Total quality of life scores were unchanged between two groups. But in the dose maintaining group, satisfaction scores of attention, autonomy, and interpersonal relationship decreased progressively. These findings suggest that the dose reduction of antipsychotics for chronic schizophrenics on programs of high-dose antipsychotics were effective. Dose reduction should therefore be implemanted to spread the rehabilitation and improve quality of life for chronic schizophrenics.

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The Association Between Neck Pain/Disability and Upper Limb Disability in Patients with Non-Specific Neck Pain (비특이성 경부통 환자의 경부통/경부기능장애와 상지 기능장애 간의 상관성)

  • Jang, Hyun-Jeon;Kim, Suhn-Yeop;Jeon, Jae-Guk;Shin, Eui-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2862-2868
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    • 2013
  • The purpose of this study was to investigate the relationship between neck pain and upper limb disability in patients with non-specific neck pain (n=132) recruited from physiotherapy departments in the Korea. Baseline neck pain/disability was measured using the Northwick Park Neck Pain Questionnaire (NPQ) and upper limb disability was measured using the Disabilities of Arm, Shoulder, Hand questionnaire (DASH). A range of baseline psychosocial variables were measured as potential confounding variables. Pairwise analysis revealed a positive correlation between NPQ score and DASH score (Pearsons' r=0.628, p<0.05). This study provides preliminary evidence that patients with severe neck pain/disability also report severe upper limb disability. The presence of severe neck pain or low pain self efficacy and high fear-avoidence beliefs questionnaire should clinicians towards a careful examination of upper limb function in patients presenting with neck pain. Our data suggest the upper limb disability may need to be addressed as part of the neck management process.

A Correlation between Stress and Activities of Daily Living related to the Ego-defense Mechanism in Stroke patients (뇌졸중 환자의 자아방어기제에 따른 스트레스와 일상생활활동 수행능력과의 상관관계)

  • Ryu, Sung-Hyun;Choi, Hyeon;Jeon, Ji-Hye;Choi, Su-Ji
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.2
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    • pp.1-9
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    • 2015
  • Objective : This study is to investigate the correlation of Ego-degense mechanism, stress and activities of daily living of stroke patients. Methods : The study was carried out from March 14, 2014 to May 15, 2015. A survey was conducted at a university hospital and three rehabilitation hospitals located in Daegu and Busan. For statistical analysis, frequency analysis, independent sample t-test, and Pearson correlation coefficient were used in this study. Results : As a result of the mature Ego-defense mechanism grop was more stressful than immature Ego-defense mechanism group(p<.05), mechanism group also showed better performance in activities of daily living activity(p<.05). Conclusion : The higher stress in stroke patients related to the disability to perform activities of daily living. Psychosocial rehabilitation for factors such as stress as well as physical function in stroke patients in the rehabilitation of stroke patients by using the Ego-defense will have a significant impact on an individual's personality or lifestyle.

A Case Report of Non-Motor Symptoms Evaluated Using the Non-Motor Symptom Scale in a Patient with Secondary Parkinsonism Presumed to be Probable Lewy Body Dementia and Improved with Combined Treatment with Herbal Medicine and Acupuncture (루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례)

  • Roh, Min-yeong;Lee, Ji-hyun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.833-845
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    • 2021
  • Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.

Effects of Participating in Tele-rehabilitation Service on Health Promotion and Quality of Life for Individuals with disability (원격재활서비스 참여가 지역사회 장애인의 건강증진 및 삶의 질에 미치는 영향)

  • Cha, Yerin;Jung, Bong-Keun;Lee, Seong A
    • 재활복지
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    • v.22 no.3
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    • pp.169-188
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    • 2018
  • The aims of this study was to investigate the effect of the Tele-rehabilitation service on health promotion and quality of life for individuals with disability. The subjects were 3 men who agreed with participating in service and were assessed of health promotion level with physical/psychological scales and quality of life. The service consists of 20 sessions for 13 weeks. The results are as follows: First, all participants improved psychosocial health promotion (subjective health level) factor. Second, physical health promotion (upper limb function, strength, range of motion) maintained and improved, but there was little change. Third, the quality of life was higher than before. In addition, qualitative research showed that participants experienced a positive change in subjective health status, emotional stability, benefit, and self efficacy, and they were satisfied with the service. Based on the results, it was shown that participation helps improve the health and quality of life of the individuals with disability in the community. This study can be used it as a basic data for establishing a Tele-rehabilitation service for individuals with disability in local community.

Evaluation and Management of Frailty, and Its Association With Pain (노쇠의 평가와 관리, 그리고 통증과의 연관성)

  • Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.32 no.1
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    • pp.1-9
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    • 2024
  • Frailty is a clinical syndrome as an increased vulnerability to stressors, leading to a decrease in physiologic reserves and a decline in the ability to maintain a good homeostasis. This condition leads to an increased risk of hospitalization, disability and mortality. Frailty occurs due to various causes and requires a multidimensional approach. It is also important to detect and manage it early. Frailty is also deeply related to neuropsychiatric problems such as pain and depression. In evaluating frailty, it is desirable to comprehensively consider not only physical areas such as disease, nutrition, movement, and sensory functions, but also psychosocial areas, and representative scales include Fried's physical frailty phenotype and Rockwood's frailty index. Physical activity and appropriate protein intake are important for frailty management, and inappropriate drug use should be reduced and oral care, cognitive function, and falls should also be noted. Frailty and pain can affect each other, and pain can promote frailty. Evidence has been published that hormone and protein abnormalities, immune system activity and inflammatory response, and epigenetic mechanisms work in common in the field of frailty and pain. More extensive and high-quality research should be conducted in the future, and the quality of life will be improved if the results are applied to the suppression and treatment of old age and pain.