• Journal of Korean Academy of Nursing
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• v.6 no.1
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• pp.72-79
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• 1976

Contemper nursing literature place much importance on human- centered and individualized care. Nursing research has related stress during hospitalization of adolescent patients to adaptation to a new environment, isolation from friends, limitation due to illness, over protection of parents and communication with member of the medical team. The investigator conducted this study in the hope that an understanding of adolescents responses to hospitalization, their perceptions, the kinds and levels of stress, and the relationships between stressors and individual characteristics would contribute to the improvement of adolescent patient care. The objective of the study was to obtain informations related to the adolescents psychological stress experience during hospitalization, specifically stress from interpersonal relationships and communication, isolation from the family, social or economic problems, illness and from the treatment environment and nursing care. An interview schedule adopted from Holmes and Rahe's Social Readjustment Rating Scale and selected items from Voicer's instrument on stress-producing events was used with 120 adolescent inpatients aged 13 to 18 years three general hospitals in Seoul during Aug. 10, to Sep. 30, 1975. 1. The sample consisted of 66 male and 54 female patients. Sixty-six percent were late adolescents, aged 16 to 18 years: 4% were early adolescents, aged 13 to 15 years. The primary cause for hospitalization was for orthopedic problems (35.8%). More than half of these (54.4%) were due to injury or accident. 2. Stress eclated to illness revealed the highest score (4.97), followed by stress related to treatment environment and nursing care (4.34) , isolation from family and social or economic problems (4.01) and interpersonal relationships and communication (3.96). 3. The perceived indifference of doctors and nurses was a serious cause of stress (mean=4.83). Fellow patients and visitors caused least stress (mean=2.06). 4. Discontinuation of education or unemployment were major stressful events (mean=4.71). Least stressful was isolation from the family (mean=3.47). 5. More than 94% of the respondents expressed fears related to body image (mean=4.97) 6. Within the category of treatment environment and nursing care, items related to restrictions because of treatment, discomfort because of treatment, inadequate explanation from nurses about procedures were rated as severe stress events (mean=4.6). Items related to the ward environment and to having a relative stay with them were seen by the group as less serious events (mean=3.7). 7. Stress related to interpersonal relationships and communication was correlated positively with female patients and those preferring passive activities. (P〈0.05) 8. Stress related to family problems was positively related to female and early adolescent patients (P< 0.05). Stress related to social problems was positively , elated to students and those preferring active pursuits (P< 0.05). 9. There were no correlation between the high stress related to disease and any of the characteristic items. (P> 0.05) 10. Stress related to treatment environment and nursing care was positively related of early adolescent and female and student patients. (P< 0.05) This group of hospitalized adolescents reported high level of stress related to treatment environment and nursing care, due to lack of consideration of normal growth and development and individual characteristics. The findings have important implications for the planning of effective, individualized, comprehensive nursing care of adolescents during hospitalization.

• Journal of Korean Academy of Nursing
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• v.22 no.1
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• pp.49-67
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• 1992

Most hospitalized children will experience physical pain as well as psychological distress. Preschool children's pain perception related to painful procedures can increase due to elevated anxiety and fear because they do not have understanding logical of their disease and hospitalization. In particular, they are distressed about needle - related procedures which are feared because they are seen to be a cause of bodily damage. This descriptive study attempted to identify pain perception levels in preschool children and their mothers. A self-reporting measurement and behavioral observation were used to collect the data. A total of 25 hospitalized preschool children and their mothers were investigated and data were collected about 60 painful procedures. Data collection was carried out by the researcher and two trained investigators from November first to December tenth. Three insruments were used to collect the data : Faces Pain Rating Scale(FPRS) developed by Beyer was used to measure the degree of preschool children's pain perception about painful procedures. The Visual Analogue Scale(VAS) devised by Huskisson was used to assess the degree of mothers' pain perception about their children's painful procedures. A Pain Behavioral Checklist based on the Procedure Behavior Check List by LeBaron and Zelter and modified by the researcher was used to observe behaviors of preschool children, their mothers, and nurses when the painful procedures took place. The data were analyzed by an SPSS program, and were tested using real numbers, percentages, Pearson correlation coefficient, t-test, and ANOVA. The results of this study are as follows : 1. Of all the painful procedures, the mean score for the FPRS for the preschool children's pain perception was 4.02 points, and the mean score for the VAS of mothers' pain perception was 10.92 points. 2. A Positive correlation which was statistically significant was found between the pain perception of preschool children and their mothers (r＝.53, p＜.01). that is, the higher the children's pain perception was, the higher their mothers' pain perception was. 3. The characteristics of the painful procedures related with children's pain perception as follows : The type of painful procedure was found to be statistically significant (F＝23.44, p＜.01), Among the three procedures Ⅳ starting was found to be perceived as the most painful procedures to the children. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝4.44, p＜.01), and the longer the duration of the procedure, the higher the pain perception wa(r＝.30, p＜.05). Pain perception in the treatment room was higher than in the children's room(t＝6.30, ＜.01), pain perception in the mother's presence was the higher than when the mother was not present (t＝2.91, p＜.01). 4. The characteristics of the painful procedures related with the mothers' pain perception as follows : The type of painful procedure was found to be statistically significant(F＝6.01, p＜.01). Among the three procedures Ⅳ sampling was found to be perceived as the most painful procedures to the mothers. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝5.95, p＜.01), and the longer the duration of the procedure, the higher the pain perception was (r＝.31, p＜.05). Pain perception in the treatment room was higher than in the children's room (t＝3.51, p＜.01), but pain perception in the mother's presence showed statistically significant no difference. 5. Of all of the 19 children's behaviors during the painful procedures, the most frequent behaviors observed Were as follows in order of frequency “crying”, “screamirig”, “facial grimacing”, “physical resistance”, Of all of the nine methers' behaviors, the most frequent by observed in “console children”, “hold children”, “applaud children”, Of all of the 11 nurses' behaviors during the painful procedures, the mast frequent in order were “smiling”, “physical restraint”, “console children”, “praise children”. 6. A positive correlation between children's and mothers' pain perception and children's behaviors was found to be statistically significant (r＝.65, p＜.01, r＝67, p＜.01). Also the relationship between children's and mothers' pain percertion, and mothers' behavior was found to be statistically significant (r＝.57, p＜. 01, 4＝.60, p＜.01). The relationship between children's pain perception and nurses' behaviors was also found to be statistically significant (r＝.46, p＜.01), but there was difference between mothers' pain perception and nurses' behaviors.

• Korean Parent-Child Health Journal
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• v.9 no.1
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• pp.3-16
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• 2006

Purpose: The purpose of this study was to provide basic data for hospitalized children under the condition of painful procedure. Method: The data were collected from July 15th to Oct 30, 2003 from 68 hospitalized children suffer from acute disease, 68 mothers take care of children, 14 pediatric ward nurses. To evaluate the degree of pain perception of children, mothers & nurses, face pain rating scale and behavior characteristic were used. Result: The result were as follows. 1) The pain perception score of children, mothers & nurses. child perceived highest as the score of 3.60 2) The most frequent behavioral characteristic children were 'crying(47.1%)' mothers were 'soothing the child(54.4%)' and nurses were 'support not to move(52.9%)' 3) The degree of pain perception of children, mothers and nurses according to subjects' general characteristics and painful procedure, there were stastical difference according to children's age, mothers age and duration of painful procedure 4) There were significant correlation between the degree of pain perception and behavioral characteristics of children, mothers & nurses. Conclusion: Nurses should not underestimate children's pain and need to provide knowledge and information to the child and their parents regarding painful procedure.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.43-50
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• 2018

Objectives Upper lumbar disc herniation (LDH) (L1/2, L2/3) has specific anatomical characteristics and different outcome after conventional treatment compared to lower LDH (L3/4, L4/5, L5/S1). The purpose of this study was to compare the clinical features and effects of korean medical treatment of upper LDH between lower LDH. Methods We retrospectively reviewed the clinical data collected from 121 patients who was had admitted at the Haeundae Jaseng Hospital of Korean Medicine from June 1st, 2014 to August 31th, 2018. The patients who had treated at L1/2, L2/3 level LDH were grouped and compared with those treated at the L3/4, L4/5, L5/S1 level. We reviewed the patient characteristics such as age, the positive rate of Straight Leg Raise Test (SLR test), the presence or absence of previous lumbar surgery. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were evaluated at adimission and discharge. Results Mean age was significantly higher at upper LDH group and positive rate of SLR test was higher at lower LDH group. There was no significant difference of gender and previous lumbar surgery between two groups. Each group had a significant improvement of NRS, ODI scores. But between two groups, there was no significant difference of NRS, ODI scores. Conclusions Upper LDH group was older than lower LDH group. SLR test was useful tool to exclude upper LDH. Korean medical treatment was significantly effective to both upper and lower LDH groups. Further well designed prospective comparative studies are needed.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.520-526
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• 2020

Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.67-75
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• 2009

Purpose: As to the analytical method of data, the various programs in which it is used for the quantitative rating of the Tl-201 myocardial perfusion SPECT are reported that there is a difference. Therefore, the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made against data of the same patient. Using quantitative index that able to represent myocardial perfusion defect level, we aimed to determine correlation among three myocardial perfusion analysis programs 4DM (4DMSPECT), QPS (Quantitative Perfusion SPECT), ECT (Emory Cardiac Toolbox) that be used generally in most departments of Nuclear Medicine. Materials and Methods: We analyzed the 145 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Mediacal Center from December 1th 2008 to February 14th 2008. We sorted as normal group and abnormal group. Normal group consist of 80 patients (Male/Female=38/42, age:$65.1{\pm}9.9$) who have low possibility of cardiovascular disease. And abnormal group consist of 65 patients (Male/Female=45/20, age:$63.0{\pm}8.7$) who were diagnosed cardiovascular disease with reversible perfusion defect or fixed perfusion defect through myocardial perfusion SPECT results. Using the 4DM, QPS, and ECT programs, the total defect extent (TDE) such as LAD, LCX, RCA and the summed stress score (SSS) have been analysed for their correlations and statistical comparison with the paried t-test for the quantitative indices analysed from each group. Results: The correlation of 4DM:QPS, QPS:ECT, ECT:4DM each group result from 145 patients is 0.84, 0.86, 0.82 at SSS, 0.87, 0.84, 0.87 at TDE, and both index showed good correlation. In paired t-test and Bland-Altman analysis results showed no statistically significant difference in the comparison of QPS:ECT at the mean SSS and TDE, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index. The correlation of 4DM:QPS, QPS:ECT, ECT:4DM program results from abnormal group (65 patients) is 0.72, 0.72, 0.70 at SSS and 0.77, 0.70, 0.77 at TDE and TDE and SSS has a good correlation. In abnormal group, paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.89) and TDE (p=0.23) comparison, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). In normal group (80 patients), paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.95) and TDE (p=0.73) comparison. And 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). Conclusions: The perfusion defect of the Tl-201 myocardial perfusion SPECT was analyzed in not only the patient in whom it has the cardiovascular disease but also the patient in whom the possibility of the cardiovascular disease is few. In the comparison of the all group research, the mean of the TDE and SSS, 4DM was lower than QPS and ECT progrms. Each program showed good correlation and the results showed statistically significant difference. However, in this way, it is determined to be compatible about the analysis value in which the large-scale side between the programs uses each program a difference in a clinical in the Bland-Altman analyzed result in spite of the good correlation and cannot use. but, this analyzed result will be able to be usefully used as the reference material for the clinical read and is expected.

• The Journal of Internal Korean Medicine
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• v.27 no.1
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• pp.188-196
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• 2006

Background: Ma-huang (Ephedra sinica) has been widely used to treat respiratory disease in oriental medicine for over a hundred years. Ma-huang preparations contain approximately 1.25% ephedrine alkaloids. Recently, the ephedra alkaloids have received much press lately due to adverse effects in those using whole extracts as 'dietary supplements' for weight loss or athletic performance enhancement, and these reports are troubling given the increasing use of Ma-huang by the general public. The purpose of this report is to determine the proper dosage to minimize adverse effects and maximize the potential curative value. Objectives : The object of this study was to find an effective yet low risk dosage of Ma-huang. Methods : The study was designed as a double-blind randomized placebo-controlled trial. The subjects of this study were 26 adults between 20 to 40 of age who agreed to participate in this study. They were allocated through randomization into three groups. Each group took three opaque capsules three times a day. A group (N=9) took one Ma-huang capsule and two placebo capsules, B group (N=8) took two Ma-huang capsules and one placebo capsule, C group (N=9) took three Ma-huang capsules. The total trial periods was two days. To compare the adverse effects of Ma-huang according to dosage, blood pressure and pulse were checked, and other adverse effects were assessed using a morning questionnaire, patient's global assessment scale and Wong-Baker faces pain rating. Results : The following result were obtained: 1. After taking 18 g of Ma-huang per day, pulse rate had a significant increase. 2. After taking more than 6 g of Ma-huang per day, palpitation would be increased significantly. 3. After taking more than 18 g of Ma-huang per day, tiredness would be increased significantly. Conclusion: According to the results, 12 g of Ma-huang per day will minimize adverse effects and maximize the potential curative value.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.186-193
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• 2020

Objectives: This study aimed to report a case that showed improvements in the symptoms of patients with alcoholic hepatitis without any indication of deterioration of the disease. Methods: Western medicine with Urusa tablets and Godex capsules and Korean medicine therapeutic approaches, including Shihogayonggolmoryo-tang, acupuncture, and moxibustion, were administered to a patient during the period of treatment. Blood tests were used to determine levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, alkaline phosphatase (ALP), gamma glutamyltransferase (GGT), total bilirubin, direct bilirubin, and total cholesterol. Fatigue was measured using the numeric rating scale (NRS), and the patient's total sleeping time was checked, daily. Results: After the combined treatment, the AST/ALT ratio and the AST, ALT, ALP, GGT, total cholesterol, and direct bilirubin levels were decreased. Through Oriental medicine for the purpose of improving symptoms, NRS of fatigue decreased from 10 to 5, and the amount of sleeping time increased from 2 to 5 hours. Conclusions: The herbal medicine had no effect on the hepatoprotective drugs such as Urusa tablets and Godex capsules used to treat alcoholic hepatitis, and no adverse reaction from the combined administration was observed. To reduce fatigue and insomnia in patients with alcoholic hepatitis, it might be helpful to combine Western medications with Korean medicine treatments, including acupuncture, moxibustion, and Shihogayonggolmoryo-tang.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.15-21
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• 2013

Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.