The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon·Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P < 0.05), female (P < 0.05), abnormal high school diploma (P < 0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P < 0.05, P < 0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.
Anorexia ; Counseling ; Dialysis ; Diet Therapy ; Diet ; Education ; Female ; Hospitals, Private ; Humans ; Kidney Failure, Chronic ; Kidneys, Artificial ; Male ; Protein-Energy Malnutrition

OBJECTIVES: The purpose of this study was to examine the success and barrier factors of hypertension registration program in Goseong community health center proven improving hypertension treatment rate by community health survey. METHODS: We conducted a qualitative research using both a performance review of the program and in-depth interviews with the 8 operators who had worked for this program in April 2018. RESULTS: In this study, the success factors were analysed as follows: First, the willingness to improve health indicators, second, the implementation of large-scale projects, third, improving program processes, fourth, continuous efforts for achievement of goal, not output or reward, and the barrier factors are as follows. First, uniform output monitering, second, evaluation after the fashion of contest, third, the confusing concept of an integrated health promotion program, fourth, the attitude of the person worried with task change. CONCLUSIONS: This study suggested that the health community health center should follow the basic principles of public health, and the central government should introduce a health policy of decentralization.
Clothing ; Community Health Centers ; Gangwon-do* ; Health Policy ; Health Promotion* ; Health Surveys ; Humans ; Hypertension* ; Politics ; Public Health ; Qualitative Research ; Reward

BACKGROUND: Numerous studies have demonstrated that spirituality has protective effects on depression. However, there are only few studies on the theoretical mechanism showing how spirituality effects on depression. Thus, to find mediating variables explaining the relationship between the spirituality and depression may help to develop appropriate program for reducing depression in elderly cancer patients. In this study, we examined the effect of optimism and pessimism as their mediating effects on depression. METHODS: This study is to verify the relationships between spirituality and depression along with the mediating effects of optimism and pessimism among 600 South Korean elderly cancer patients who participated in a community-based study about their mental health. RESULTS: Optimism and pessimism are linked with spirituality and depression. Higher spirituality levels were associated with increased optimistic thinking, and then optimistic thinking is associated with low possibility of depression, whereas lower spirituality levels were associated with more pessimistic thinking, and in turn pessimistic thinking is associated with high depression scores. CONCLUSIONS: Understanding optimism and pessimism affecting depression level is critical for developing spirituality-based programs to reduce depression in elderly cancer patients.
Aged* ; Depression* ; Humans ; Mental Health ; Negotiating* ; Optimism* ; Pessimism* ; Spirituality* ; Thinking

OBJECTIVES: This study investigated the improvement of food habits and eating behavior of cancer patients during treatment through the continuous nutrition counseling and monitoring. METHODS: Thirty cancer patients during treatment were participated in this study, and the first nutrition counseling and the first and second monitoring were conducted after 2-3 week intervals. RESULTS: As a result of the nutrition counseling and monitoring, all patients improved to a great extent to consume 3 meals a day. The frequency of having breakfast was significantly increased with the nutrition counseling and continuous monitoring as well. The meal fixed quantity was stabilized and the eating speed slowed down as more nutrition counseling were done. The snack intakes of patients did not show any significant difference after the nutrition counseling but showed a slight decline after the monitoring. The frequencies of eating out and a late-night meal significantly decreased after the monitoring. The intakes of fish, meat, vegetables, milk and fruits needed for a well-balanced diet significantly increased as more nutrition counseling were done. The intakes of processed food were significantly decreased after the nutrition counseling and the intakes of fast food were significantly decreased as more nutrition counseling were done. The water intake of patients also significantly increased. In the eating behavior related to health, the frequency of drinking alcohol significantly decreased after nutrition counseling consultation and no patients had dietary supplements after the first monitoring. CONCLUSIONS: These results suggested that continuous nutrition counseling is effective in improving eating habits of cancer patients.
Breakfast ; Counseling* ; Diet ; Dietary Supplements ; Drinking ; Eating ; Fast Foods ; Feeding Behavior ; Food Habits ; Fruit ; Humans ; Meals ; Meat ; Milk ; Snacks ; Vegetables

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.
Aged ; Appetite ; Caregivers* ; Fatigue ; Gyeonggi-do ; Humans ; Medical Records ; Medical Staff* ; Quality of Life* ; Seoul

BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS: The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.
Depression ; Epidemiologic Studies ; Gangwon-do ; Gyeonggi-do ; Hospitals, University ; Humans ; Problem Solving ; Seoul ; Social Problems ; Social Work ; Social Workers

BACKGROUND: Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. METHODS: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10–19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. RESULTS: The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=−3.534, P < 0.001). And the social problem solving ability of experimental group was significantly improved (Z=−2.908, P=0.003). CONCLUSIONS The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.

BACKGROUND: This research is an exploratory study that is based on previous studies focusing on relationship between the doctors and the elderly cancer patients; moreover, the research focuses on the doctors' negative attitudes and discriminative behaviors towards the elderly cancer patients so that we may be able to suggest the ways to decrease the ageism. METHODS: Qualitative method and quantitative method were applied sequently. In this research, we practiced in-depth interviews with 8 doctors and then the surveys with 274 doctors. The in-depth interview questions were categorized depending on meaningful testimonies and the survey data were analyzed in the descriptive statistic analysis and paired t-test using PASW statistics 18. RESULTS: Through the in-depth interviews, the following is observed: the doctors rarely notify the elderly cancer patients directly; the family members of patients avoids the doctors to do so; and the doctors even show different attitudes or discriminatory actions to the elderly. Based on the in-depth interview results, the questions on notifying methods of the diagnosis and how to explain for treatment were developed and performed as a survey. Through the survey, only 8.4% of the doctors reported they directly notify the elderly cancer patient; moreover, they also reported they provide less information on treatment, side-effects, prognosis, and medical cost to the elderly than the middle-aged. CONCLUSIONS: This research not only discovered the presence of discrimination towards the elderly cancer patients but also suggested the causes of it. In order to resolve the phenomenon, doctors must consider individualized difference and variability of physiological function and should be aware of the psychological change after the cancer diagnosis to better communicate with them. Additionally, the social family culture which overprotects the elderly must be changed.
Aged* ; Ageism* ; Diagnosis* ; Disclosure* ; Discrimination (Psychology) ; Humans ; Methods ; Prognosis

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Adult Children ; Attention ; Caregivers* ; Depression* ; Education ; Gyeonggi-do ; Health Occupations ; Hospitals, University ; Humans ; Nursing ; Optimism* ; Outpatients ; Seoul

Pluripotent stem cells (PSCs) have been considered as the most important cells in regenerative medicine as they are able to differentiate into all types of cells in the human body. PSCs have been established from several sources of embryo tissue or by reprogramming of terminally differentiated adult tissue by transduction of so-called Yamanaka factors (Oct4, Sox2, Klf4, and cMyc). Interestingly, accumulating evidence has demonstrated the residence of PSCs in adult tissue and with the ability to differentiate into multiple types of tissue-committed stem cells (TCSCs). We also recently demonstrated that a population of pluripotent Oct4(+) SSEA-1(+)Sca-1(+)Lin-CD45(-) very small embryonic-like stem cells (VSELs) resides in the adult murine bone marrow (BM) and in other murine tissue. These very small (~3-6 microm) cells express pluripotent markers such as Oct4, Nanog, and SSEA-1. VSELs could be specified into several tissue-residing TCSCs in response to tissue/organ injury, and thus suggesting that these cells have a physiological role in the rejuvenation of a pool of TCSCs under steady-state conditions. In this review article, we discuss the molecular nature of the rare population of VSELs which have a crucial role in regulating the pluripotency, proliferation, differentiation, and aging of these cells.
Adult* ; Aging ; Antigens, CD15 ; Bone Marrow ; DNA Methylation ; Embryonic Structures ; Genomic Imprinting ; Human Body ; Humans ; Pluripotent Stem Cells ; Regenerative Medicine ; Rejuvenation ; Stem Cells*