BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

BACKGROUND: Family counseling is an essential part of family practice in which patients are cared in psychosocial dimension as will as in physical dimension and the family is dealt with as a whole unit. However, it is little applied in practice. The department of family medicine has made efforts to activate family counseling. This study was done to estimate the patients response on the effect of family counseling that we have performed, and to investigate what clinical problems counseling was held and in what situations the counseling was perceived to be useful by the patients. We hope this study will be useful to establish some useful data and ideas for the development of family counseling in family practice in Korea. METHODS: The subjects of this study are 53 households who received family counseling at the department of family medicine from Oct. 1, 1994 to May 31, 1995. 64 households received counseling during this peroid, but 11 persons who could not be reached by the phone were excluded. Patients demographic charateristics, patients chief complaints, physicians assessrnent on the complaints and major prolems presented in the counseling sessions were identified from the medical records. Patients own estimation of the effect of counseling and the reasons for termination of counseling were inquired through the telephone interview. Finally the association between the usefulness of counseling and some factors was statistically analyzed. RESULTS: Subjects were predominently women(84.9%), especially middle aged. The most common chief complaint was headache complained by 10 subjects (18.9%), and the second and the third were abdominal pain complained by 8 (15.1%) and chest discomfort complained by 7(13.2 %), respectively. The list of physicians assessment included depression(34.0%), physical symptom per se without any assessment(20.8%), family problem(15.1%), somatization(13.2%), and anxiety(9.45). More than half of the subjects(60.4%) had only one session, 26.4% two sessions and 7.5% more than 4 sessions. The most common problem presented in the counseling was marital conflict(28.3%), the second was trouble with in-laws(15.1%), and the third was chronic illness in the family(9.4%). 32.1% replied that the counseling was very helpful, 28.3% somewhat helpful, 17% little helpful, 20.8% never helpful, and 1.9% not sure. The session was experienced to be more useful in the group of duration of symptom less than 6 months, than in the group of longer duration(p<0.05), and in the group with motivation for counseling than in the group without motivation(p<0.05). CONCLUSIONS: About 60% of subjects replied the counseling was useful to them. Symptom duration and patients motivation to participate in counseling showed significant association with the effect of family counseling.
Abdominal Pain ; Chronic Disease ; Counseling* ; Family Characteristics ; Family Practice ; Headache ; Hope ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Middle Aged ; Motivation ; Thorax

OBJECTIVES: The objective of this study was to compare the parent-child relationship of adolescents with depression and those without depression, by using Parent-Child Relationship Instrument (PCRI), Family Relationship Scale (FRS), and Parenting Attitude Test-Youth (PAT-Y). We also investigated the association between the parent-child relationship and depressive symptoms. METHODS: Twenty-five adolescents with depression (age 15.0+/-2.1 years, 8 boys) and 24 adolescents without depression (age 13.7+/-1.3 years, 16 boys) completed the Adolescent-General Behavior Inventory (A-GBI), Adolescent-Mood Disorder Questionnaire (A-MDQ), Beck Depression Inventory (BDI), PCRI, and PAT-Y. The parents of subjects completed the Child Behavior Checklist, Parent-General Behavior Inventory 10-item Mania Scale (P-GBI-10M), Parent-Mood Disorder Questionnaire, and FRS. Independent t-tests, analysis of covariance, and partial correlation analysis were used. RESULTS: The Intimacy (p=.002) and Respect (p=.029) scores of the PCRI were significantly higher in adolescents without depression compared to those with depression. The Intimacy scores of the PCRI showed negative correlation with the BDI and P-GBI-10M and the Strictness scores of the PCRI showed positive correlation with the A-GBI, A-MDQ, and BDI. The Inconsistency, Punishment, and Excessive Expectation scores of the PAT-Y showed positive correlation with the A-GBI and BDI scores. CONCLUSION: Our results suggest a possible association of the parent-children relationship and parenting attitude with adolescents' depressive symptoms.
Adolescent* ; Bipolar Disorder ; Checklist ; Child ; Child Behavior ; Depression* ; Family Relations ; Humans ; Parent-Child Relations* ; Parenting ; Parents ; Punishment ; Surveys and Questionnaires

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

We rotated the nucleus up to 270 degree and dislocated it into anterior chamber through the diameter of capsulorhexis after hydrodissection by using the planned extracapsular cataract extraction. And later on we delivered the nucleus with hydroexpression using the irrigating Vectis or with rotation using a lens spatuala. As a result of this procedure, the nucleus was safely delivered in all cases without zonular rupture and vitreous prolapse.
Anterior Chamber ; Capsulorhexis* ; Cataract Extraction* ; Cataract* ; Prolapse ; Rupture

PURPOSE: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). METHODS: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and χ2-test. RESULTS: Although there was no significant difference in 75g OGTT (χ2=.11, p=.748) or self-management (t=−1.28, p=.206), there was a statistically significant increase in self-efficacy (t=−2.02, p=.048) in the experimental group compared to that in the control group. CONCLUSION: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.
Blood Glucose ; Counseling ; Diabetes, Gestational* ; Education ; Female ; Glucose Tolerance Test ; Humans ; Postnatal Care* ; Postpartum Period ; Pregnancy ; Self Care* ; Telephone

Purpose: The purpose of this study was to describe the profile of graduates from accelerated second-degree Bachelor of Science in Nursing programs and to analyze the relative efficiency of nursing colleges using data envelopment analysis. Methods: An online survey link was emailed to the deans of nursing colleges, who were then asked to send the link to graduates of the respective colleges. The survey questionnaire included demographics, reasons for applying to the accelerated second-degree Bachelor of Science in Nursing program, employment after graduation, and nursing career satisfaction. Results: Sixty-two graduates of the accelerated second-degree Bachelor of Science in Nursing program responded to the survey. The mean age at admission was 24.28 (± 3.01) years. Reasons for applying to the accelerated second-degree Bachelor of Science in Nursing program were primarily increasing job security and using it as a stepping stone to another career. Nursing career job satisfaction was 4.81 (± 1.07) and more than 82% recommended this program. The data envelopment analysis found the average efficiency score to be 0.84 (± 0.20) and 4 nursing colleges to be relatively efficient. Conclusion The accelerated second-degree Bachelor of Science in Nursing program can be considered to be an effective means to produce quality nurses with non-nursing bachelor degrees in a short time; however, outcomes of this program need to be systematically monitored to maintain quality level. Through this, competent nurses with knowledge of adjacent studies will be added to the nursing workforce.

BACKGROUND AND OBJECTIVE: There has been little clinical data on the treatment outcome of patients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical p arameters obtained from this protocol. METHOD: A total of 32 cases with acute asthma were treated with oxygen, beta2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. RESULT: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between beta2 agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium of aminophylline(n=15, 4.17+/-0.45 vs. 3.99+/-0.35mM/L, p<0.05), compared with patients using only beta2 agonist and methylprednisolone(n=17, 3.89+/-0.30 vs. 4.14+/-0.45mM/L, p>0.05). CONCLUSION: Subcutaneous beta2 agonist may be an alternative to inhalant beta2 agonist for the emergency treatment of acute asthma, and we think a consensus regarding use of aminophylline in the emergency room should be made.
Aminophylline ; Asthma* ; Consensus ; Emergency Service, Hospital ; Emergency Treatment ; Heart Rate ; Humans ; Inhalation ; Ipratropium ; Korea ; Methylprednisolone ; Oxygen ; Potassium ; Respiratory Rate ; Treatment Outcome*

To suggest a reasonable isometric point based on the anatomical consistency of interosseous membrane (IOM) attachment in association with topographic characteristics of the interosseous crests, the footprints of the central band (CB) of the IOM on the radial and ulnar interosseous crests (RIC and UIC) were measured. Methods: We measured the distance from the CB footprints from each apex of both interosseous crests in 14 cadavers and the angles between the forearm axis of rotation (AOR) and the distal slopes of the RIC and UIC in 33 volunteers. Results: The CB footprints lay on the downslope of both interosseous crests with its upper margin on average 3-mm proximal from the RIC’s apex consistently in the radial length, showing normality (p>0.05), and on average 16-mm distal from the UIC’s apex on the ulna without satisfying normality (p<0.05). The average angle between the UIC’s distal slope and the AOR was 1.3°, and the RIC’s distal slope to the AOR was 14.0°, satisfying the normality tests (p>0.05), and there was no side-to-side difference in both forearms (p<0.05). Conclusions: The CB attached to the downslope just distal to the RIC’s apex constrains the radius to the UIC that coincides with the AOR of the forearm circumduction, maintaining itself both isometrically and isotonically.