OBJECTIVE: To examine the effect of cold spray (Ethyl chloride) on reducing pain during needle electromyography (EMG). METHOD: Seventy-six adults, who had experienced needle electromyographic examination, were studied. They were randomly assigned to either experimental or control group. In experimental group, cold spray was applied to needling point of examining muscles before each needle examination. In control group, needle examination was performed without pre-treatment. The intensity of pain was assessed by the Visual analogue scale (VAS) and Verbal rating scale (VRS). Denial to re-examination was evaluated after EMG study. RESULTS: The VAS, VRS and denial to re-examination were significantly lower in experimental group (p<0.05). CONCLUSION: The application of cold spray before needle examination decreased the intensity of pain and denial to re-examination.
Adult ; Denial (Psychology) ; Electromyography* ; Humans ; Muscles ; Needles*

PURPOSE: The purpose of this paper is to identify a theoretical basis of end-of-life care by examining attributes of the concept of the nurses' acceptance of patient deaths. METHODS: Walker and Avant's approach to concept analysis was used. A literature study was performed to check the usage of the concept. To identify the attributes of the concept and come up with an operational definition, we analyzed 16 qualitative studies on nurses' experiences of death of patients, published in a national science magazine from 1999 to 2015. RESULTS: The nurses' acceptance of death of patients was identified as having four attributes: acceptance through mourning, attaining insight on life and death while ruminating life, facing with fortitude and practicing human dignity. Antecedents of the concept were experiences of patient's death, confusion and conflict, negative emotions, passive responses, denial of patients' death. The consequences of the concept were found as the holistic end-of-life care and active pursuit of life. CONCLUSION: This study on the attributes of the concept of the nurses' acceptance of death of patients and it's operational definition will likely lay the foundation for applicable end-of-life care mediations and theoretical development.
Denial (Psychology) ; Grief ; Humans ; Periodicals as Topic ; Personhood ; Walkers

OBJECTIVES: To study the mechanism of alcohol craving is difficult because it involves both cognitive and emotional processes, which are discordamtly influenced by patients' avoidance and denial. The objective of this study is to examine the mechanism of craving by evaluating responses of emotional component of alcohol-related stimuli, explicitly and implicitly. METHODS: The subject group was composed of 19 patients with alcohol dependence, 25 heavy drinkers, and 20 social drinkers. An implicit association test (IAT) measuring differential association of 2 target concepts (alcohol versus beverage) with 2 attribute dimensions (positive versus negative) was completed. Explicit evaluation of emotional valence and arousal for alcohol-related and control stimuli was also completed. RESULTS: The patient group reported alcohol-related stimuli more negatively on both implicit and explicit evaluation. In explicit arousal evaluation, they evaluated alcohol-related stimuli more arousing than control stimuli, whereos control groups did not. While the strength of alcohol-negativity association was not related to any clinical variables, the strength of alcohol-positivity association was related to the arousal level of alcohol related stimuli, the severity of alcohol dependence, and the mean drinking amount per occasion. CONCLUSION: Alcohol craving can be regarded as negative emotion on both explicit and implicit levels in alcoholics. It seems that craving induced by alcohol-related stimuli may not be recognized by the patients but related to increased arousal or positive implicit evaluation of alcohol.
Alcoholics ; Alcoholism* ; Arousal ; Cues* ; Denial (Psychology) ; Drinking ; Humans

OBJECTIVES: Although previous studies have suggested that Type 1 or Type C personality may be associated with the development of cancer, the results have not been consistent. There have been some evidences that repression, denial, or non-expression of anger are related with the incidence of colorectal cancer. However, according to the results of recent researches, aggressive hostility was related to the development of colorectal cancer. This study attempted to delineate psychological characteristics or personality patterns of the patients with colorectal cancer based on multidemensions of anger and Type 1 personality for cancer development. METHOD: The subjects were composed of 35 patients with colorectal cancer and 37 normal controls. Grossarth-Maticek personality questionnaire and the Spielberger state-trait anger expression inventory were administered. RESULTS: In comparison with the normal control group, the colorectal cancer patient group showed significantly higher scores on anger experience, angry temperament and state anger but no significant differences on Type 1 personality scale and other subscales. In the discriminant analysis patients and control groups were classified by means of state anger, angry temperament, angry reaction, anger-in, anger-out and anger control variables. When angry temperament variable was selected as a discriminant variable, 65.8% of cases had been correctly classified. CONCLUSIONS: These results suggested the relationship between the disposition to experience and express anger without particular provocation and the development of cancer.
Anger* ; Colorectal Neoplasms* ; Denial (Psychology) ; Hostility ; Humans ; Incidence ; Surveys and Questionnaires ; Repression, Psychology ; Temperament

OBJECTIVES: This subjects investigated the psychological characteristics of patients with functional dyspepsia. METHODS: The subjects included ninety patients with functional dyspepsia and sixty four psychiatric out-patients. We administered Minnesota Multiphasic Personality Inventory (MMPI) and Illness Behavior Questionnaire(IBQ). RESULTS: There were no significant differences between the patients with functional dyspepsia and the psychiatric out-patients by MMPI. Two groups both showed a higher distribution in hypochondriasis, depression, hysteria subscales than in any other subscales. The patients with functional dyspepsia showed lower scores in disease conviction and affective disturbance subscales in IBQ subscales were similar between the patients with functional dyspepsia and the psychiatric out-patients. The patients with functional dyspepsia were divided into three groups for the Multivariate cluster analysis: normal(group 1), similar to psychiatric out-patient(group 2), and severe neurotic(group 3). The severe neurotic group showed higher scores in hypochondriasis, depression, hysteria, psychathenia, and schizophrenia subscales in MMPI and showed significant different scores in affective disturbance, disease conviction, psychological and somatic concerns, affective disturbance, denial, and irritability subscales in IBQ. CONCLUSION: If patients with functional dyspepsia show severe neurotic behavior, such as those in(group 3), they would need appropriate psychiatric intervention.
Denial (Psychology) ; Depression ; Dyspepsia* ; Humans ; Hypochondriasis ; Hysteria ; Illness Behavior ; MMPI ; Outpatients ; Psychology* ; Schizophrenia

PURPOSE: This study is to explore the relationships among spirituality, death anxiety and burnout level of nurses caring for cancer patients. METHODS: Participants were 210 nurses from a cancer hospital in Seoul. Data were collected from April until June 2012 and analyzed using t-test, one-way ANOVA, Scheffe's test, and Pearson's correlation coefficient. RESULTS: The mean score for spirituality was 3.51 out of six. Among sub-categories, the one that scored the highest was the purpose and meaning of life, followed by unifying interconnectedness, inner resources and transcendence. The mean score for death anxiety was 3.22, and the sub-categories in the order of high score were denial of death, awareness of the shortness of time, pure death anxiety and fear of matters related to death. For the burnout, the mean was 4.10. Among sub-categories, highest mark was found with emotional exhaustion, followed by depersonalization and personal accomplishment. The spirituality level was negatively correlated with those of death anxiety and burnout. Death anxiety was positively correlated with burnout levels. Nurses with the higher spirituality level also had a higher level of education and experience of spiritual education, believed in the existence of God. In contrast, death anxiety and burnout levels were higher among those with a lower level of education, atheists, and for those who answered that religion has little influence on life. CONCLUSION: Thus, it is necessary to provide spiritual interventions for nurses who care for cancer patients to develop their spirituality, reduce death anxiety and prevent them from burning out easily.
Anxiety* ; Burnout, Professional ; Burns ; Cancer Care Facilities* ; Denial (Psychology) ; Depersonalization ; Education ; Humans ; Spirituality*

OBJECTIVE: We investigated whether Disability Evaluation (DE) situations influence patients' neuropsychological test performances and psychopathological characteristics and which variable play a role to establish an explanation model using statistical analysis. METHODS: Patients were 536 (56.6%) brain-injured persons who met inclusion and exclusion criteria, classified into the DE group (DE; n = 300, 56.0%) and the non-DE group (NDE; n = 236, 44.0%) according to the neuropsychological testing's purpose. Next, we classified DE subjects into DE cluster 1 (DEC1; 91, 17.0%), DE cluster 2 (DEC2; 125; 23.3%), and DE cluster 3 (DEC3; 84, 15.7%) via two-step cluster analysis, to specify DE characteristics. All patients completed the K-WAIS, K-MAS, K-BNT, SCL-90-R, and MMPI. RESULTS: In comparisons between DE and NDE, the DE group showed lower intelligence quotients and more severe psychopathologic symptoms, as evaluated by the SCL-90-R and MMPI, than the NDE group did. When comparing the intelligence among the DE groups and NDE group, DEC1 group performed worst on intelligence and memory and had most severe psychopathologic symptoms than the NDE group did. The DEC2 group showed modest performance increase over the DEC1 and DEC3, similar to the NDE group. Paradoxically, the DEC3 group performed better than the NDE group did on all variables. CONCLUSION: The DE group showed minimal "faking bad" patterns. When we divided the DE group into three groups, the DEC1 group showed typical malingering patterns, the DEC2 group showed passive malingering patterns, and the DEC3 group suggested denial of symptoms and resistance to treatment.
Brain ; Brain Injuries ; Denial (Psychology) ; Disability Evaluation ; Humans ; Intelligence ; Malingering ; Memory ; MMPI ; Neuropsychological Tests

OBJECTIVES: Psychoeducation is an important factor in the treatment of chronic mental illness that increases drug compliance, then prevents relapse of illness, and brings the patient a progress of social function and quality of life. The purpose of this study was to elucidate the effect of psychoeducation on relapse of schizophrenic patients. METHODS: Checklist including 33 items was applied to 97 schizophrenic patients that had been treated at Seoul National Mental Hospital. The subject was divided into two groups. The experimental group consisted of 47 cases that were not treated consistently more than 6 months in outpatient department and required at least 3 time hospital treatment. The control group consisted of 50 cases that were treated consistently in outpatient department at least 3 consecutive years. RESULTS: The experimental group had significant differences in terms of deficiency of insight such as denial of disease or relapse, subjective experience of drug side effect, whether or not taking drug and they had higher negative attitude to therapist. Many schizophrenic patients reported that they had not been educated thoroughly about disease, drug, and prognosis. 46.8% in experimental group and 46.0% in control group did not recognized necessity of psychoeducation. CONCLUSION: This study suggested that we need the necessity of psychoeducation in terms of the relationship between the relapse of illness and psychoeducation. However, considering that we did not have an extensive study about psychoeducation and compliance, we need more improved study.
Checklist ; Compliance ; Denial (Psychology) ; Hospitals, Psychiatric ; Humans ; Outpatients ; Prognosis ; Quality of Life ; Recurrence* ; Schizophrenia ; Seoul

BACKGROUND: An elective operation is cancelled by many causes. Cancellation of the operation bothers patients physically and emotionally; also it affects the patient's family emotionally. If we know the causes of cancellation, we can prevent them. In addition we can provide better quality medical service. METHOD: We examined all patients scheduled for an operation in An - am Hospital, Korea University from August 3rd, 1999 to September 19th, 1999 and from September 16th, 1999 to December 6th, 1999. We counted the number of operations which were cancelled on the day of operation and put together the causes of cancellation after asking surgical employees. RESULTS: The total numbers of scheduled patients was 2,494 and cancelled patients was 512. The overall cancellation rate was 20.5%. The most common cause was departmental, 48.4%; abnormal laboratory results, 24.8%; patients denial, 9.6%; inadequate preparation, 7.0%; overtime, 5.5%; or a change to local anesthesia, 4.7%. In the departmental causes, 52% was due to an excessive schedule (129/248); 32.3% to delayed admission (80/248); 8.9% to clerical error (22/248); 4.4% to operator problems (11/248); and 1.6% to delayed transfer (4/248). In the abnormal laboratory results, 27.6% were due to the medical causes (35/127); 23.6% to LFT (30/127); 23% to an EKG (23/127); 18% to a chest roentgenogram (18/127); 8.7% to a URI (11/127); and 5.5% to hypertension (7/127). CONCLUSIONS: Overall the cancellation rate of elective surgery was 20.5%. The most common cause was departmental (48.7%), and abnormal laboratory results (24.8%) was next.
Anesthesia, Local ; Appointments and Schedules ; Denial (Psychology) ; Electrocardiography ; Humans ; Hypertension ; Korea ; Thorax

Peripartum cardiomyopathy is a cardiac condition characterized by development of heart failure during the last month of pregnancy or during the first five months of post partum period without any other identifiable cause of heart failure. The hypercoagulable state in the pregnancy along with left ventricular (LV) systolic dysfunction predisposes the patient to thromboembolic complications like intraventricular thrombi. We report a case of a 30-year-old female with peripartum cardiomyopathy along with a highly mobile mass in the LV cavity on two dimensional echocardiography. Three dimensional transthoracic echocardiography clearly showed the pedicle of the mass attached to the interventricular septum along with internal echolucent areas within the mass. Due to denial of the patient to undergo surgery, she was started on oral anticoagulation, with complete dissolution of the mass within one month.
Adult ; Cardiomyopathies* ; Denial (Psychology) ; Echocardiography ; Echocardiography, Three-Dimensional* ; Female ; Heart Failure ; Humans ; Peripartum Period* ; Pregnancy ; Thrombosis*