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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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Public Attitudes Toward Dying with Dignity and Hospice.Palliative Care (품위 있는 죽음과 호스피스.완화의료에 대한 일반 국민들의 태도)

  • Yun, Young-Ho;Rhee, Young-Sun;Nm, So-Young;Chae, Yu-Mie;Heo, Dae-Seuk;Lee, So-Woo;Hong, Young-Seon;Kim, Si-Young;Lee, Kyung-Sik
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.17-28
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    • 2004
  • Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

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Public Attitudes toward Development of National Program for Cancer Survivorship (암 생존자를 위한 국가 프로그램 개발에 대한 일반 국민들의 태도)

  • Bae, Yeon-Min;Kim, Young-Ae;Hong, Sung-Hoo;Koo, Ja-Hyun;Yun, Young-Ho
    • Journal of Hospice and Palliative Care
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    • v.14 no.4
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    • pp.218-226
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    • 2011
  • Purpose: This study aimed to explore the public attitude toward the development of national health program for cancer survivorship. Based on the results of this survey suggest the necessity of national health program for cancer survivorship. Methods: We surveyed 1,015 adults who were over 20 years of age from the sixteen cities and local districts of Korea. We conducted a telephone survey with a structured questionnaire on the post-treatment care at the nation and on the permission as the handicapped for cancer. Results: Fifty-six percent of respondents answered that post-treatment program at the national level is very necessary and twenty-seven percent replied that it is necessary. Respondents emphasized 'Expanding insurance coverage for post-treatment care' (29.8%) and 'Systematic education and rehabilitation programs after treatment' (25.6%). This study found that a lower educational level [adjusted odds ratio (aOR)=1.36; 95% confidence interval (CI)=1.04~1.77], earning under 300 per month [aOR=1.36; 95% CI=1.04~1.77], being married (60.2%) [aOR=1.79; 95% CI=1.34~2.37] and thought higher level of cancer treatment in Korea than the advanced (64.4%) [aOR=1.56; 95% CI=1.15~2.12] influenced the positive attitude toward a national health program. Sixty-eight percent of respondents answered 'Strongly agree' or 'agree' to permission for cancer survivors as the handicapped. People who have been married (72.4%) [aOR=1.89; 95% CI=1.41~2.53] and who have had a lower educational level [aOR=1.35; 95% CI=1.03~1.78] responded that they agree more to permission for cancer survivors as the handicapped. Conclusion: This study shows the positive public attitude of the public toward the national health program for the cancer survivors.

Comparison of Science Gifted and Ordinary Elementary School Students with Regard to the Concept of Groundwater (초등학교 과학영재학생과 일반학생의 지하수에 대한 개념 비교)

  • Lee, Hyong-Jae;Park, Sang-Tae
    • Journal of Gifted/Talented Education
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    • v.22 no.4
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    • pp.855-874
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    • 2012
  • This research aimed to obtain basic data for elementary school students to form proper concepts by comparing the science gifted students and the ordinary students of elementary school with regard to the groundwater concept, formation process, existence forms, and movement. The research subjects were 65 fifth and sixth graders of the elementary school students and the spatial ability test was conducted on the subjects, and 4 science gifted students and 8 ordinary students chosen from the subjects were analyzed using half-structured interview data and ground water drawing drawn by the students. The conclusion derived in accordance with the research purpose is summarized as follows. It was found that there were no great differences in the answers to the question asking what groundwater is between the science gifted elementary school students with high spatial ability and the ordinary elementary school students with moderate spatial ability. The ordinary students with low spatial ability tended to regard groundwater as the concept of water and sewage. In the concept of the formation process of groundwater, the science gifted elementary school students with high spatial ability explained it by citing diverse surface water such as rainfall, river water, lake, and waterfall, and the ordinary elementary school students with moderate spatial ability all mentioned only rainfall and river water and could not explain diverse spatial factors. The ordinary elementary school students with low spatial ability mentioned rainfall and river water and perceived that groundwater was formed artificially. In the concept regarding the existence form of groundwater, the ordinary elementary school students with low spatial ability could not think of space perception that small pore space exists in earth or soil in the ground. The science gifted elementary school students with high spatial ability knew that groundwater exists in pore space with regarding groundwater movement, the ordinary elementary school students with low spatial ability thought that there was no groundwater movement and that it could be moved only by artificial facilities. There were differences in the perception of pore space and in the perception of existence and non-existence of groundwater movement accordingly, but for most of the elementary school students, the concept of groundwater was formed differently from the scientific concept. It is considered that most of the elementary school students formed erroneous concept about groundwater and could not connect ground water under the surface of the earth with the substances forming its surroundings with regard to the concept of groundwater.

Risk factors for food allergy among children in Seoul: focusing on dietary habits and environmental factors (서울시 일부 아동의 식품알레르기 위험요인 : 식품 섭취와 환경적 요인을 중심으로)

  • Jang, Mijung;Kim, KyooSang
    • Journal of Nutrition and Health
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    • v.52 no.6
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    • pp.559-568
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    • 2019
  • Purpose: This study examined the prevalence of food allergies and allergenic factors in a selected sample of children living in Seoul, Korea, along with their dietary habits, environmental factors, and diseases as risk factors for food allergy. The results of this study will provide basic data for addressing food allergies. Methods: We selected 3,004 pre-school and school-age children, aged 0 ~ 12, in the 25 districts of Seoul as the study sample. Structured self-report questionnaires were administered over a two-month period in July-August 2018, and the children's parents recorded the answers on their children's behalf. The research tools in this study included the Korean version of the questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC). Results: The physician-diagnosed prevalence rate of food allergies was 14.2%, while 20.4% of the children experienced allergic symptoms at least once and 17.4% reported symptoms within the previous 12 months. The children's symptoms included skin problems (88.1%), gastrointestinal issues (19.2%), oral issues (16.7%), respiratory issues (12.7%), and systemic issues (1.3%). The causes of allergies included eggs, peaches, milk, peanuts, and shrimps. The factors influencing the experience of food allergies were the consumption of cereal (aOR, 1.52; 95% CI, 1.09 ~ 2.10; p = 0.013), potatoes (aOR, 1.88; 95% CI, 1.33 ~ 2.65; p < 0.001), and fast food (aOR, 1.73; 95% CI, 1.10 ~ 2.72; p = 0.017). Having food allergy symptoms was associated with a higher risk of experiencing asthma (aOR, 4.22 95% CI, 3.10 ~ 5.76; p < 0.001), allergic rhinitis (aOR, 2.53; 95% CI, 2.03 ~ 3.15; p < 0.001), and atopic dermatitis symptoms (aOR, 3.56; 95% CI, 2.88 ~ 4.40; p < 0.001). Conclusion: Episodes of food allergies warrant examining regular food consumption and placing dietary restrictions through early diagnosis as these episodes may imply the presence of other allergies. Our findings offer basic insights into the patterns, prevalence and symptoms of children's food allergies in Seoul, and our findings will contribute to identifying effective interventions for food allergies.

Chardin's Genre Paintings of Child Education: The Enlightenment Views on Children of the French Bourgeois Class in the 18th Century (샤르댕의 아동 교육 장르화 - 18세기 프랑스 부르주아의 계몽주의적 아동관)

  • Ko, Yu-Kyoung
    • The Journal of Art Theory & Practice
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    • no.8
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    • pp.33-58
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    • 2009
  • This paper examines four genre paintings on the subject of child education by Jean-Baptiste-Sim${\'{e}}$on Chardin(1699-1779). The Governess, The Diligent Mother, Saying Grace, and The Morning Toilette garnered critical attention after they were exhibited in the Salon from 1739 to 1741. After the exhibition, the paintings were made into prints and frequently sold to members of the bourgeois class in Paris. The iconographical details of Chardin's genre paintings have, thus far, been compared to Dutch genre pictures of the seventeenth century. Further, most studies conducted on Chardin's paintings focus on formal analysis rather than the historical and social contexts. Through attempting social-contextual readings of Chardin's educational series, this paper argues that the significance of Chardin's painting series of child education lies in his representation of the ideal French bourgeois family and the standard of early childhood education in the eighteenth-century French Enlightenment period. In each of the four child education paintings, Chardin depicted a mother with children in a domestic space. Even though this theme derives from traditional Dutch genre paintings in the seventeenth century, the visual motifs, the pictorial atmosphere and the painting techniques of Chardin all project the social culture of eighteenth century France. Each painting in the child education series exemplifies respectively the attire of a French gentlemen, the social view on womanhood and the education of girls, newly established table manners, and the dressing up culture in a 'toilette' in eighteenth century France. Distinct from other educational scenes in previous genre paintings, Chardin accentuated the naive and innocent characteristics of a child and exemplified the mother's warmth toward that child in her tender facial expressions and gesturing. These kinds of expressions illustrate the newly structured standard of education in the French Enlightenment period. Whereas medieval people viewed children as immature and useless, people in the eighteenth century began to recognize children for their more positive features. They compared children to a blank piece of paper (tabula rasa), which signified children's innocence, and suggested that children possess neither good nor bad virtues. This positive perspective on children slowly transformed the pedagogical methods. Teaching manuals instructed governesses and mothers to respect each child's personality rather than be strict and harsh to them. Children were also allotted more playtimes, which explains the display of various toys in the backgrounds of Chardin's series of four paintings. Concurrently, the interior, where this exemplary education was executed, alludes to the virtue of the bourgeois's moderate and thrifty daily life in eighteenth century France. While other contemporary painters preferred to depict the extravagant living space of a French bourgeoisie, Chardin portrayed a rather modest and cozy home interior. In contrast to the highly decorated living space of aristocrats, he presented the realistic, humble domestic space of a bourgeois, filled with modern household objects. In addition, the mother is exceptionally clad in working clothes instead of fashionable dresses of the moment. Fit to take care of household affairs and children, the mother represents the ideal virtues of a bourgeois family. It can be concluded that the four genre paintings of child education by Chardin articulate the new standards of juvenile education in eighteenth century France as well as the highly recognized social virtues between French bourgeois families. Thus, Chardin's series of child education would have functioned as a demonstration of the ideal living standards of the bourgeois class and their emphasis on early childhood education in the French Enlightenment period.

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Sentiment analysis on movie review through building modified sentiment dictionary by movie genre (영역별 맞춤형 감성사전 구축을 통한 영화리뷰 감성분석)

  • Lee, Sang Hoon;Cui, Jing;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
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    • v.22 no.2
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    • pp.97-113
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    • 2016
  • Due to the growth of internet data and the rapid development of internet technology, "big data" analysis is actively conducted to analyze enormous data for various purposes. Especially in recent years, a number of studies have been performed on the applications of text mining techniques in order to overcome the limitations of existing structured data analysis. Various studies on sentiment analysis, the part of text mining techniques, are actively studied to score opinions based on the distribution of polarity of words in documents. Usually, the sentiment analysis uses sentiment dictionary contains positivity and negativity of vocabularies. As a part of such studies, this study tries to construct sentiment dictionary which is customized to specific data domain. Using a common sentiment dictionary for sentiment analysis without considering data domain characteristic cannot reflect contextual expression only used in the specific data domain. So, we can expect using a modified sentiment dictionary customized to data domain can lead the improvement of sentiment analysis efficiency. Therefore, this study aims to suggest a way to construct customized dictionary to reflect characteristics of data domain. Especially, in this study, movie review data are divided by genre and construct genre-customized dictionaries. The performance of customized dictionary in sentiment analysis is compared with a common sentiment dictionary. In this study, IMDb data are chosen as the subject of analysis, and movie reviews are categorized by genre. Six genres in IMDb, 'action', 'animation', 'comedy', 'drama', 'horror', and 'sci-fi' are selected. Five highest ranking movies and five lowest ranking movies per genre are selected as training data set and two years' movie data from 2012 September 2012 to June 2014 are collected as test data set. Using SO-PMI (Semantic Orientation from Point-wise Mutual Information) technique, we build customized sentiment dictionary per genre and compare prediction accuracy on review rating. As a result of the analysis, the prediction using customized dictionaries improves prediction accuracy. The performance improvement is 2.82% in overall and is statistical significant. Especially, the customized dictionary on 'sci-fi' leads the highest accuracy improvement among six genres. Even though this study shows the usefulness of customized dictionaries in sentiment analysis, further studies are required to generalize the results. In this study, we only consider adjectives as additional terms in customized sentiment dictionary. Other part of text such as verb and adverb can be considered to improve sentiment analysis performance. Also, we need to apply customized sentiment dictionary to other domain such as product reviews.

Role accomplishment and job satisfaction of hospice nurse (호스피스간호사의 역할수행 정도와 직무만족도)

  • Han, Hyoung-Suk;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.29-48
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    • 2008
  • Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

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Activation plan of social safety network of the aged living alone - Focused on the aged using wireless paging system in Gwangyang-si - (독거노인의 사회안전망에 대한 활성화 방안 - 광양시 무선페이징시스템 대상자 중심으로 -)

  • Lee, Jae-Min
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.41-58
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    • 2009
  • Objective : The purpose of this study is to identify actual operations and issues of wireless paging system operation for the aged living alone as the end users of wireless paging system primarily in Gwangyang city, and thereby to explore possible advanced and integrated ways to promote social safety network for the aged. Methods : The survey tool used in this study was a structured questionnaire form consisting of question items. The researcher hereof conducted this survey by means of direct visit and interview during two seasons, i.e. from February to August, 2008 and from December 2008 to March 2009, respectively. Results : 1) For general demographic characteristics, it was found that 90.9% of all respondents were women and 61.2% of all respondents were at age 75 to 84. for health conditions, it was found that more than 90% of all respondents often took medicines due to their unhealthy body, and most of respondents suffered from musculoskeletal diseases 79.3% and circulatory diseases 61.6%. for walking capacity, it was found that 45.5% of all respondents used walking aids, and disable respondents (11.5% of all respondents) were represented primarily by those with physical disability (52.6% of disable respondents). for actual use of medical institutions, it was found 47.3% of all respondents relied on local clinics, since they preferred neighborhood hospitals or clinics they can trust for medical care. for social activities and supports, it was found that 43.6% respondents had 'needs for assistance at times' and 33.9% respondents have 'no need for assistance'. And it was found that the major difficulties in living alone at old age were represented primarily by health problems 37.8% and economic difficulties 33.5%. 2) For characteristics related to wireless paging system, it was found that 90.3% respondents used wireless paging system recommended by firemen, and 28.5% respondents used this system. and it was found that 59.6% respondents used this system once, and 85.2% respondents used it because of acute or chronic diseases. more than 90% respondents thought that they knew about wireless paging system and considered themselves safe, but 83.6% respondents didn't attach a remote control on their upper clothes, and even 49.1% respondents turned off the power of wireless paging system due to their concern about electricity bill and noise. 3) It was found that 83.6% respondents felt it necessary to use wireless paging system, and wireless paging users felt more satisfied with using the system than non-users, and 50.7% showed high satisfaction at certain psychological benefits like 'confidence in coping with critical situations' and 'a sense of relief'. In addition, it was found that some respondents who answered that 'they didn't turn off the paging system as they knew how it works' and those who answered that they knew 'how to use it' showed relatively high satisfaction. And some respondents who kept it well and felt it necessary also showed high satisfaction. 4) It was found that the level of satisfaction our respondents felt with using wireless paging system varied significantly availability($x^{2}$ = 12.759, p = .002), psychological advantages($x^{2}$ = 12.174, p = .002), knowledge about how to use system($x^{2}$ = 7.021, p = .016), power on/off($x^{2}$ = 13.221, p = .001), level of knowledge about system($x^{2}$ = 21.002, p = .000), maintenance($x^{2}$ = 9.871, p = .007) and level of necessity($x^{2}$ = 34.939, p = .000) on the statistical basis.

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A Study on Radiation Management Status and Exposure Anxiety Awareness of Dental Hygienist (치과위생사의 방사선 안전 관리 실태 및 피폭 불안감 인식)

  • Kang, Eun-Ju;Hyeong, Ju-Hee
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.172-181
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    • 2015
  • This study intends to improve the radiation safety management and the recognition for handling radiation using structured questionnaires to dental hygienists working at Jeollabuk-do from September 1 to October 31 in 2014. As a result, 63% of respondents have not received education for radiation safety management. Moreover, the practical degree for radiation safety management was $2.58{\pm}1.11$, while the degree of knowledge was $3.74{\pm}0.83$ of total 5.0. The results of insecurity for radiation danger were high as $3.88{\pm}0.92$, and insecurity for fetus during pregnancy shows the highest value as $4.43{\pm}0.71$. From the results of statistical significance level, the knowledge degree of radiation safety management is affected by total numbers of radiograpy for a day (p<0.05), and the practical degree of radiation safety management is affected by age group, academic background, monthly income, continuous service year, practice area, present position, and status of radiography in present (p<0.05). In addition, the knowledge degree of radiation safety management have a negative correlation (r=-0.232) with the practical degree, but have a positive correlation (r=0.262) with the insecurity for radiation danger. The high knowledge degree of radiation safety management (${\beta}=0.252$, p<0.001) and the short radiography work period (${\beta}=-0.341$, p<0.05) were the influential factors to the insecurity for radiation danger. Consequently, countermeasures are necessary to encourage dental hygienists to put their radiation safety management knowledge into the practice and to reduce the insecurity degree for radiation danger. Furthermore, it is important to prevent psychological and physical risks by radiation exposure through the improvement of radiation safety management level and recognition for handling radiation to improve medical environment.