PURPOSE: The purpose of this study was to evaluate food carving among hemodialysis patients and to identify factors affecting the food carving. METHODS: hemodialysis between March 15 and April 15, 2017. Measurement instruments included the general food craving questionnaire trait, the center for epidemiological studiesdepression scale, and stress response inventory-modified form. The statistical analysis included t-test, analysis of variance, pearson correlation analysis, and stepwise multiple regression analysis. RESULTS: Mean food craving score was 53.00±12.36. Food craving was higher in patients younger than 40 years (F=4.36 p=.006) and having occupation (t=2.18 p=.031). Patients receiving hemodialysis demonstrated higher levels of depression (21.37±9.62) and stress (39.68±15.95). Factors influencing food craving were depression (β=.52, p<.001), stress (β=.65, p<.001), and age 50~59 years old (β=−.28, p=.001) and 60~69 years old (β=−.19, p=.026), which accounted for 25.6% of total variance. CONCLUSION: Food craving among hemodialysis patients was influenced by patients' depression, stress and age. Assessment and management of depression and stress needs to be incorporated as a nursing strategy for dietary management for hemodialysis patients.
Craving ; Depression ; Humans ; Nursing ; Occupations ; Renal Dialysis ; Stress, Psychological

OBJECTIVES: The purpose of this study was to examine the factors associated with fear of falling among the elderly dwelling in rural communities. METHODS: From February 1, 2010 to March 31, 2010, a questionnaire-based survey was sent to 2,628 persons 65 years or older dwelling in 1 Myeon and 1 Eup of Gyeongsangnam-do. Among these participants, 735 (27.9%) had fallen more than once in 2009. For data analysis, descriptive statistics and hierarchical multiple regression were performed using SPSS version 12.0. RESULTS: Factors influencing the fear of falling in the elderly according to falls experienced were number of outpatient visits, number of falls, gender, admission, purchasing of health function foods, and activities of daily living. Overall, the study showed significant differences in the score of fear of falling according to gender, age, education, marital status, living arrangement, main means of mobilization, drinking, income, number of falls, admission, number of outpatient visits, experience with outpatient oriental medicine, purchasing of health function foods, medical assistance devices, season, fall location, fall cause, shoe type, injury type, limitation of activity, and activities of daily living. CONCLUSIONS: The results of this study suggest that programs should be developed specifically for elderly people who have experienced more than one fall because of increased fear due to multiple falls.
Activities of Daily Living ; Aged ; Drinking ; Humans ; Marital Status ; Medical Assistance ; Medicine, East Asian Traditional ; Outpatients ; Residence Characteristics ; Rural Population ; Seasons ; Shoes ; Statistics as Topic

Purpose: This study aimed at developing a happiness assessment scale for middle-aged women (HAS-MW) in Korea. Methods: Preliminary items for the scale were drafted from the results of literature review and personal interviews and open-ended questions with women in the community. The interviews were based on the theory of existence, relatedness, and growth. After validating a preliminary scale, we analyzed the validity and reliability of the new scale items, and model fit. We surveyed 600 women aged 40 years to 64 years for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Valid data were divided into 352 for EFA and 174 for CFA by multiplies of number 1 to 3. Results: Using exploratory and confirmatory factor analyses, we extracted four primary factors—self-value, positive thinking, self-care, and family relationship—and with a total of 24 items for HAS-MW. The fit of the final model was evaluated as good showing χ2/df = 2.10, goodness of fit index = .80, comparative fit index = .85, root mean square error of approximation = .08, standardized root mean residual = .05. The HAS-MW had a significant positive correlation with the Oxford Happiness scale and showed a significant negative correlation with the Hwa-Byeong Scale. Cronbach's α for the new scale was .91, and the Spearman-Brown half coefficient was .93. The new scale used a five-point Likert scale with higher scores indicating greater happiness. Conclusion The HAS-MW is a reliable and valid one. It can be used to measure the level of happiness for middle-aged women. In addition, it might be applied to find low women and to evaluate the effect of intervention program related to happiness in woman of middle age.

Purpose: This study aimed at developing a happiness assessment scale for middle-aged women (HAS-MW) in Korea. Methods: Preliminary items for the scale were drafted from the results of literature review and personal interviews and open-ended questions with women in the community. The interviews were based on the theory of existence, relatedness, and growth. After validating a preliminary scale, we analyzed the validity and reliability of the new scale items, and model fit. We surveyed 600 women aged 40 years to 64 years for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Valid data were divided into 352 for EFA and 174 for CFA by multiplies of number 1 to 3. Results: Using exploratory and confirmatory factor analyses, we extracted four primary factors—self-value, positive thinking, self-care, and family relationship—and with a total of 24 items for HAS-MW. The fit of the final model was evaluated as good showing χ2/df = 2.10, goodness of fit index = .80, comparative fit index = .85, root mean square error of approximation = .08, standardized root mean residual = .05. The HAS-MW had a significant positive correlation with the Oxford Happiness scale and showed a significant negative correlation with the Hwa-Byeong Scale. Cronbach's α for the new scale was .91, and the Spearman-Brown half coefficient was .93. The new scale used a five-point Likert scale with higher scores indicating greater happiness. Conclusion The HAS-MW is a reliable and valid one. It can be used to measure the level of happiness for middle-aged women. In addition, it might be applied to find low women and to evaluate the effect of intervention program related to happiness in woman of middle age.

Transfusion-associated circulatory overload (TACO) is recently becoming more important than transfusion-related acute lung injury (TRALI) in terms of the number of patients with definite diagnosis as well as its prognosis. In order to diagnose TACO, it is helpful to recognize early the symptoms suspicious of transfusion reaction through electronic medical record system and computer network, and this will be of help for obtaining samples for brain natriuretic peptide (BNP) measurement before and after the onset of transfusion reaction. We report a case in which a transfusion reaction was diagnosed as TACO. A 62-year-old woman was admitted to the emergency room due to bleeding tendency. Two fresh frozen plasma units and one unit of leukocyte-reduced red blood cells were transfused. Blood pressure increased during transfusion, and the chest X-ray showed findings suggestive of newly developed pulmonary edema. N-terminal prohormone of BNP (NT-proBNP) test was carried out using the specimens in refrigerated storage. Compared with the NT-proBNP level measured 12 hours before the transfusion, that measured 6 hours after the transfusion was markedly increased (>48 fold of pre-transfusion level). As a result, this case was diagnosed with TACO.
Acute Lung Injury ; Blood Pressure ; Diagnosis ; Electronic Health Records ; Emergency Service, Hospital ; Erythrocytes ; Female ; Hemorrhage ; Humans ; Middle Aged ; Natriuretic Peptide, Brain ; Plasma ; Prognosis ; Pulmonary Edema ; Thorax ; Transfusion Reaction

BACKGROUND: Red blood cell (RBC) transfusion is one of the major treatments for correcting anemia, but its use should be carefully considered because of adverse transfusion reactions and inappropriate usage. Therefore, individual health care facilities have self evaluated their use of transfusion in an attempt to decrease unnecessary procedures. In this study, we evaluated the differences in the minimum hemoglobin (Hb) trigger for RBC transfusion among clinical departments in Severance Hospital. METHODS: We analyzed the electronic medical records of RBC transfusion episodes that were conducted at a Hb level above 8 g/dL from July 2014 to September 2015. We classified these data by clinical department, and considered the overall medical conditions of the patients. The minimum Hb trigger level in this study was defined as the lowest Hb level within 24 hours prior to RBC transfusion. RESULTS: A total of 4,953 RBC transfusion episodes that were conducted at Hb levels above 8 g/dL were analyzed over that period. In general, the minimum Hb trigger level was higher in the operation group than the hemorrhage group. When compared among clinical departments, the department of orthopedic surgery, neurosurgery, rehabilitation medicine, and anesthesiology showed high levels of minimum Hb trigger equal to or greater than 10 g/dL. CONCLUSION: The minimum Hb trigger level differed among clinical departments, with the operation group showing a much higher level of minimum Hb trigger. We hope that these data will be practically applied to establish plans and strategies for managing the appropriateness of RBC transfusions in Korea. In addition, continuous evaluation and transfusion education for clinical departments should be performed.
Anemia ; Anesthesiology ; Delivery of Health Care ; Education ; Electronic Health Records ; Erythrocyte Transfusion* ; Erythrocytes* ; Hemorrhage ; Hope ; Humans ; Korea ; Neurosurgery ; Orthopedics ; Rehabilitation ; Transfusion Reaction ; Unnecessary Procedures

With increasing travel to tropical area, the number of patients with imported malaria in this country is increasing. RBC exchange transfusion has proposed as a adjunct therapy for very severe falciparum malaria to reduce the parasite load rapidly. We report a patient with severe Plasmodium falciparum infection with 26% of erythrocyte parasitized, treated with RBC exchange transfusion in addition to conventional chemotherapy. The exchange of 1200 mL of red blood cells was carried out with 7 packed red cells using automatic cell separator. This patients recovered from his disease despite respiratory distress syndrome and acute renal failure. We conclude that RBC exchange is a useful adjunct to conventional chemotherapy and should be considered in patients with severe and complicated falciparum malaria.
Acute Kidney Injury ; Drug Therapy ; Erythrocytes ; Humans ; Malaria ; Parasite Load ; Plasmodium falciparum* ; Plasmodium*

OBJECTIVES: This study aimed to confirm the efficacy of the urinary fluoride concentration/creatinine ratio for monitoring fluorine intake in fluoridated and non-fluoridated communities. METHODS: The correlations among the fluoride concentration in drinking water and that in the urine and fingernails of 52 preschool children (age, 60-72 months) from fluoridated and non-fluoridated communities were analyzed. RESULTS: The urinary fluoride concentration/creatinine ratio had a relatively high correlation with the fluoride concentration in drinking water (Pearson's correlation coefficient, 0.606; P<0.05). Further, this ratio was significantly positively correlated with the urinary fluoride concentration (Pearson's correlation coefficient, 0.374; P<0.01). However, there was no significant correlation between this ratio and the fluoride concentration in fingernails (Pearson's correlation coefficient, 0.145; P>0.05). CONCLUSIONS: The findings of this study suggest that the urinary fluoride concentration/creatinine ratio in children can be utilized as an index for monitoring excess fluoride intake in fluoridated communities.
Child ; Child, Preschool ; Drinking ; Drinking Water ; Fluoridation ; Fluorides ; Fluorine ; Humans ; Nails

BACKGROUND: The accumulation of lipoprotein and monocyte in the intima of the arterial wall is the most important step of the development of coronary artery disease (CAD). Lipoprotein lipase (LPL) plays an anti-atherogenic role by lipolysis of triglyceride-rich lipoproteins, but, it may also act as a receptor of some lipoproteins and monocyte at the arterial wall and act as a atherogenic molecule. Previous studies showed somewhat contradictory results about the association of CAD and LPL polymorphisms and mutations. Racial and dietary difference may contribute to these contradictory results. In this study, we tried to find out the association of CAD and the genetic variation of the LPL (PvuII RFLP in intron 6, HindIII RFLP in intron 8 and Ser 447 Ter mutation in exon 9) in Korean population. METHOD AND RESULT: CAD patients (n=146), confirmed by coronary angiography and healthy Korean adult volunteers (n=110) were genotyped for PvuII/HindIII RFLP and Ser447Ter mutation of the LPL gene by PCR-digestion method. Between two groups, the genotype frequency of these genetic variations was not different. But, the genetic variations showed different effect on lipid profile and body mass index (BMI) in the CAD group and in the control group. In the CAD group, P1 allele carriers showed higher total cholesterol (P1P1+P1P2:P2P2=216+-51 mg/dl:198+/-38 mg/dl, p=0.039) and higher LDL cholesterol level (P1P1+P1P2:P2P2=143+/-46 mg/dl:126+/-36 mg/dl, p=0.047), and H1 allele carriers had lower Body mass index than non-carriers (23.8+/-2.3 kg/m2 :24.8+/-2.9 kg/m2 , p=0.047). In the control group, the Ser447Ter mutation carriers had higher HDL cholesterol level than non-carriers (59+/-10mg/dl versus 53+/-11mg/dl, p=0.049) and patients with P1 allele showed lower body mass index (P1P1+P1P2: P2P2=23.1+/-2.6 kg/m 2 :24.5+/-2.6 kg/m2 , p=0.006). CONCLUSION: In Korean, PvuII/HindIII RFLP and Ser447Ter mutation was not associated with CAD, and they showed different effect on the lipid profile and on the body mass index according to the study group. These results suggests that the phenotypic characteristics of the LPL gene of the Korean people are different from those of occidental people.
Adult ; Alleles ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Exons ; Genetic Variation ; Genotype ; Humans ; Introns ; Lipolysis ; Lipoprotein Lipase* ; Lipoproteins* ; Monocytes ; Polymorphism, Restriction Fragment Length ; Volunteers

PURPOSE: The purpose of this study was to construct and test a structural equation modeling on burnout of clinical nurses based on CS-CF model. METHODS: A survey using a structured questionnaire was conducted with 557 clinical nurses. Data were analyzed using structural equation modeling. RESULTS: The modified hypothetical model yielded the following chi2=289.70, p<.001, RMSEA=.09, GFI=.93, TLI=.91, CFI=.94, PCFI=.65, AIC=363.21, SRMR=.05 or less and showed good fit indices. Nursing work environment, patient safety culture and resilience showed indirect effects on burnout while compassion fatigue and compassion satisfaction had direct effects. CONCLUSION: Results of this study suggest that compassion fatigue must be decreased and compassion satisfaction has to be increased, while burnout is lowered by enhancing the clinical nursing work environment, patient safety culture and resilience. In addition, more variables and longitudinal studies are necessary to validate the clear cause-and-effect relationship between the relevant variables.
Adult ; *Burnout, Professional ; Empathy ; Fatigue ; Female ; Humans ; Job Satisfaction ; Male ; *Models, Theoretical ; Nursing Staff, Hospital/*psychology ; Questionnaires ; Resilience, Psychological ; Workplace