• Child Health Nursing Research
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• 제6권2호
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• pp.199-211
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• 2000

Today, more chronically ill and handicapped children are being cared for at home by a family member caregiver. The task of caring for a family member may feel burden that the caregiver has less time and money and more work. Family functioning and their burden have influence on coping and adaptation of families with chronically-ill children. This study attempted to identify the levels of burden and family functioning in families of children with cerebral palsy and to examine their relationships. The instruments were burden scale developed by Suh and Oh(1993), and a modified Feetham Family Functioning Survey based on Roberts and Feetham.(1982). The subjects were 98 parents of children, under 15 years, who have cerebral palsy and being treated and living in Pusan. Data were collected through a self-administered question- aire from April 26 to May 29. The collected data were tested using frequencies, percentiles, means, t-test, ANOVA, and Pearson correlation coefficient with SPSSWIN program. The results of this study were as follows ; 1. The mean rating scores of burden and family functioning were 2.79±.51 and 4.12±.69, respectively. 2. The relationships between general character- istics and burden were statistically significant difference : degree of children's handicap(F=6.333, P<.01). The relationships between general characteristics and family functioning were statistically significant differences : familial relation with the children(F=3.628, P<.05), caregiver's health status(F=4.359, P<.05), age of children (F=4.185, P<.05), and duration of treatment (F=6.802, P<.01). 3. In families of children with cerebral palsy, there was significantly negative correlation between the burden of parents and the performance of family functioning(r=-.230, P<.05). There were significantly negative correlations between the burden of parents and the satisfaction of family functioning (r=-.211, P<.05), and between the perceived importance and the satisfaction of family functioning(r=-.481, P<.01); however, there was a positive correlation between the performance and the perceived importance of family functioning(r=.425, P<.01). In conclusion, this study suggests that families of children with cerebral palsy need family-focused nursing interventions as supportive care for relieving their burden and for improving family functioning.

• Tuberculosis and Respiratory Diseases
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• 제47권5호
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• pp.660-668
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• 1999

연구배경: 폐암의 발생은 접점 증가추세로 65세 이상환자가 전체 폐암의 50% 정도를 차지하지만, 잦은 만성 질환의 동반, 각종 장기의 기능저하로 수술, 방사선치료나 항암화학요법과 같은 적극적 치료를 감당하지 못할 것을 우려하여 적절한 치료를 받지 못하고 있어 노령 폐암환자의 임상적 특성의 분석을 통하여 향후 이들에 대한 대책수립하고자 본 연구를 시행하였다. 방 법: 1994년 9월부터 1998년 8월사이에 서울특별시립 보라매 병원에 입원하여 폐암으로 진단받은 환자 207명을 대상으로, 65세이상의 I군과 65세미만의 II군으로 분류하여 후향적 분석을 하였다. 결 과: 60대에서 36.2%로 가장 높은 발병률을 보였고, 65세 이상의 남자환자가 전체환자의 42%였다. I군에서 호흡곤란을 주소로 하는 환자가 유의하게 많았으나, 이외의 증상이나 병기, 조직학적 분류상두군간에 유의한 차이는 없었다. ECOG기준 활동도 3, 4인 환자가 II군의 12.9%에 비해 I군에서는 35.2%로 많았다. 소세포폐암의 치료는 두 군간에 차이가 없었으나, 비소세포폐암 환자는 II군의 35%에 비해 I군 환자의 74%가 보존적 치료만을 받았고, 수술이나 근치적 방사선치료를 받은 환자는 I군에서 14%에 불과하였다. 두 군간에 생존을 비교하면 I군의 중앙생존기간이 10개월로 II군의 17.4개월에 비해 떨어지지만, 보존적 치료외에 어떠한 치료라도 받았던 환자에서는 두군간에 차이를 보이지 않았다. 활동도, 병기, 조직학적 아형만이 다변량분석시 생존에 영향을 미치는 유의한 인자였고 연령은 생존과 무관한 인자였다. 결 론: 폐암은 노령환자의 질환이라고 할만큼 65세 이상에서 호발하며, 환자의 연령에 의해서 예후가 결정되는 것이 아니므로 노령환자라 하더라도 폐암에 대한 적극적 진단 및 치료가 필하다고 하겠다.

• 근관절건강학회지
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• 제6권2호
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• pp.211-225
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• 1999

This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

• 근관절건강학회지
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• 제7권1호
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• pp.5-24
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• 2000

Middle age for women is one of the most important stages of the whole normal life span and has unique problems concerning the psychological and physical health, specifically degenerative musculoskeletal diseases. Therefore middle age women should prepare in order to lead a healthy and fruitful life as they enter/begin old age. As the population of middle age women increase, the demands of nurses who care for this age group also continue to glow. Nurses must be interested in this middle age group of women in Korea. This study was designed to identify the extent of family support and self-esteem of the middle age women with degenerative musculoskeletal diseases and the relationship between them and nurse's contribution to middle age women's health promotion that maintain and promote qualify of her life. The population of this study was 112 women aged 40-60, attending the out patient clinic one University Hospital and one Hospital, in Pusan. The data was collected from 1st August to the 30th of September, 1998 by using 36 items questionnaire. The instrument used for measuring family support was of Chai's(1983) FSS which was modified by Kang's(1984) Family Support Scale. And that for self-esteem was Rosenberg's(1965) Self-esteem Scale. The reliability of Chai's FSS and Rosenberg's instruments were tested by Cronbach's alpha and showed that they were 0.93 and 0.89 each respectively. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS computer program. The results of the study were summarized as follows : 1. The mean score of the perceived family support was $39.31{\pm}9.42$. 2. The mean score of the perceived self-esteem was $33.16{\pm}6.75$. 3. Statistically significant factors influencing the family support among sociodemographic variables was satisfaction of marriage(F=-3.069, p<0.003). 4. Statistically significant factors influencing the self-esteem among sociodemographic variables were age(F=3.992, p=0.000), education(F=2.260, P=0.026), housing (F=-1.987, P=0.049) and satisfaction of marriage(F=-2.305, P=0.023). 5. There was a significant correlation between family support and self-esteem (r=.621, p<.000). In conclusion, perceived the family support was important for middle age women to increase their self-esteem. Nurses should be aware of the necessity of family support in the supportive nursing of middle age women and should be able to make a plan to educate the family about supporting the wife/mother. The continuing study of the health promotion of middle age women to find out variables influencing middle age women' health must continue.

• Tuberculosis and Respiratory Diseases
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• 제68권3호
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• pp.168-174
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• 2010

Background: Sepsis still has a high mortality rate despite adequate supportive care. Newer therapeutic modalities have been developed but they have generally ended in failure. Recently, insulin was reported to have an anti-inflammatory effect by inhibiting the $I{\kappa}B/NF-{\kappa}B$ pathway, and may have therapeutic potential in sepsis. However, the precise mechanism of the anti-inflammatory effect of insulin is unclear. This study examined the role of insulin in activating $I{\kappa}B/NF-{\kappa}B$ in macrophage. Methods: Raw 264.7 cells, a murine macrophage cell line, were used in this experiment. Western blotting using $I{\kappa}B$ Ab and phosphor-specific $I{\kappa}B$ Ab was performed to evaluate the degradation and phosphorylation of $I{\kappa}B$ cells. For the $I{\kappa}B$ Kinase (IKK) activity, an immune complex kinase assay was performed. The level of interleukin-6 (IL-6) was measured by ELISA to determine the level of proinflammatory cytokine. Results: $I{\kappa}B{\alpha}$ degradation began 30 min after lipopolysaccharide (LPS) treatment. However, an insulin pretreatment suppressed the $I{\kappa}B{\alpha}$ degradation caused by the LPS treatment. The phosphorylation of $I{\kappa}B{\alpha}$ and IKK activity was also inhibited by the insulin pretreatment. Finally, the insulin pretreatment showed a tendency to suppress the induction of IL-6 by LPS. Conclusion: Insulin might have an anti-inflammatory effect though partial inhibition of the $I{\kappa}B/NF{\kappa}B$ pathway in macrophage cell lines.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.30-36
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• 2018

Purpose: We investigated complications after laparoscopic sentinel basin dissection (SBD) for patients with gastric cancer who were enrolled in a quality control study, prior to the phase III trial of sentinel lymph node navigation surgery (SNNS). Materials and Methods: We analyzed prospective data from a Korean multicenter prerequisite quality control trial of laparoscopic SBD for gastric cancer and assessed procedure-related and surgical complications. All complications were classified according to the Clavien-Dindo Classification (CDC) system and were compared with the results of the previously published SNNS trial. Results: Among the 108 eligible patients who were enrolled in the quality control trial, 8 (7.4%) experienced complications during the early postoperative period. One patient with gastric resection-related duodenal stump leakage recovered after percutaneous drainage (grade IIIa in CDC). The other postoperative complications were mild and patients recovered with supportive care. No complications were directly related to the laparoscopic SBD procedure or tracer usage, and there were no mortalities. The laparoscopic SBD complication rates and patterns that were observed in this study were comparable to those of a previously reported trial. Conclusions: The results of our prospective, multicenter quality control trial demonstrate that laparoscopic SBD is a safe procedure during SNNS for gastric cancer.

• 성인간호학회지
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• 제13권1호
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• pp.53-69
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• 2001

As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

• Clinical and Experimental Pediatrics
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• 제57권3호
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• pp.125-134
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• 2014

Purpose: The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. Methods: The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. Results: The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short followup duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. Conclusion: We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.412-418
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• 2010

Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

• 대한약침학회지
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• 제15권2호
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• pp.31-35
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• 2012

Background and Objectives: Non-small-cell lung cancer (NSCLC) represents approximately 80% of all lung cancers. Unfortunately, at their time of diagnosis, most patients have advanced to unresectable disease with a very poor prognosis. The oriental herbal medicine HangAm-Plus (HAP) has been developed for antitumor purposes, and several previous studies have reported its therapeutic effects. In this study, the efficacy of HAP was evaluated as a third-line treatment for advanced-stage IIIb/IV NSCLC. Methods: The study involved six patients treated at the East- West Cancer Center (EWCC) from April 2010 to October 2011. Inoperable advanced-stage IIIb/IV NSCLC patients received 3,000 or 6,000 mg of HAP on a daily basis over a 12-week period. Computed tomography (CT) scans were obtained from the patients at the time of the initial administration and after 12 weeks of treatment. We observed and analyzed the patients overall survival (OS) and progression-free survival (PFS). Results: Of the six patients, three expired during the study, and the three remaining patients were alive as of October 31, 2011. The OS ranged from 234 to 512 days, with a median survival of 397 days and a one-year survival rate of 66.7%. In the 12-week-interval chest CT assessment, three patients showed stable disease (SD), and the other three showed progressive disease (PD). The PFS of patients ranged from 88 to 512 days, the median PFS being 96 days. Longer OS and PFS were correlated with SD. Although not directly comparable, the OS and the PFS of this study were greater than those of the docetaxel or the best supportive care group in other studies. Conclusion: HAP may prolong the OS and the PFS of inoperable stage IIIb/IV NSCLC patients without significant adverse effects. In the future, more controlled clinical trials with larger samples from multi-centers should be conducted to evaluate the efficacy and the safety of HAP.