PURPOSE: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. METHOD: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). RESULT: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. CONCLUSION: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.
Self Efficacy* ; Smoke* ; Smoking Cessation* ; Smoking* ; Ulsan

PURPOSE: This study was conducted to identify the caring experience of the mothers of childhood burn patients. METHODS: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. RESULTS: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. CONCLUSION: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.
Adaptation, Psychological ; Anxiety ; Burns ; Child ; Child Rearing ; Cicatrix ; Depression ; Frustration ; Guilt ; Humans ; Mothers ; Siblings ; Thinking

BACKGROUND: Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. METHOD AND MATERIALS: The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale(MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index-Side Effect Scale(EISE). RESULTS: A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demographic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group 1.39+/-0.61 ; amitriptyline group 2.00+/-0.85, p<.001). At the 4-PISE. There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. CONCLUSIONS: In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.
Adolescent ; Amitriptyline* ; Depression ; Double-Blind Method ; Drug Therapy ; Dysthymic Disorder* ; Follow-Up Studies ; Humans ; Moclobemide*

PURPOSE: This study is aimed at identifying the effects of telephone counseling as nursing support on distress, anxiety, depression, and adverse events in cancer patients undergoing their first chemotherapy. METHODS: This was a randomized controlled trial (pretest-posttest design). A total of 70 patients who showed 4 or higher distress scores were selected from the screening process. Four patients dropped out; therefore, 66 patients participated in this research. Thirty-two and 34 patients were randomly assigned to the experimental and the control group, respectively. After a preliminary survey, telephone counseling support was given to the experimental group at three time points. The post survey was done before the second cycle of chemotherapy. RESULTS: Regarding distress, both groups showed a statistically significant decrease in the scores: 3.4 for the experimental group and 1.8 for the control group (p=.002). Furthermore, the experimental group demonstrated a statistically significant decrease relative to the control group. Anxiety and depression showed no statistically significant difference between the two groups. CONCLUSION: This study concludes that nursing support through phone counseling is effective in decreasing distress in patients undergoing chemotherapy for the first time.
Anxiety* ; Counseling* ; Depression* ; Drug Therapy* ; Humans ; Mass Screening ; Nursing ; Telephone*

The depressive symptoms are frequent and important ones in the elderly population. We studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly (more than 65 years old; n=490) in Seoul area (city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination (MMSE) Geriatric Depression Scale (GDS) Korean Depression Scale(KDS: under development)were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1)the loss of spouse, 2)a current physical illness, and 3)low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.
Aged* ; Depression* ; Education ; Humans ; Logistic Models ; Marital Status ; Memory ; Seoul ; Social Class ; Spouses

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.
Colorectal Neoplasms ; Humans ; Mucous Membrane ; Neoplasm Recurrence, Local ; Recurrence

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.
Colorectal Neoplasms ; Humans ; Mucous Membrane ; Neoplasm Recurrence, Local ; Recurrence

PURPOSE: The purpose of this study was to identify the reactions of emergency department nurses to violence. METHODS: Q-methodology which provides a method of analyzing the subjectivity of each item was used. Thirty emergency department nurses classified 33 selected Q-statements into a normal distribution using a 9 point scale. The collected data was analyzed using the Quanl PC Program. RESULTS: Three types of reactions to violence were identified. The first type(emotional and physical reactions) showed a sense of regret on the selection of an occupation and emotional and physical reactions such as anxiety, fear, depression, hopelessness, heart palpitations and trembling hands due to the violence. The second type(problem solving) actively coped to prevent the occurrence of violence, grasped the causes of violence and sought out a problem solving plan. The third type(anger reactions) felt a lot of anger against violence, and resented their reality of working under conditions of inadequately secured facilities and systems. CONCLUSION: The emotional and physical reactions type and the anger reactions type should be required to attend educational programs to improve attitudes and abilities to solve the problems in a more active and positive manner.
Adult ; *Attitude of Health Personnel ; Demography ; *Emergency Nursing ; Female ; Humans ; Interviews as Topic ; Male ; Nurses/*psychology ; Q-Sort ; *Violence

An acquired tracheoesophageal fistula (TEF) is a rare complication that can occur in the treatment of laryngeal cancer. Explosive coughing from the tracheostomy-opening site after swallowing is a warning sign of the TEF. A 68-year old male laryngeal cancer patient showed delayed TEF after chemoradiotherapy with a total laryngectomy.The clinicians carrying out a videofluoroscopic swallowing study should be familiar with the total laryngectomy state, as well as the findings and initial general management of TEF. This report discusses the pathophysiology and management of TEF and the needs for dysphagia care team after chemoradiation in laryngeal cancer patients.

We report a case of a healthy 38-year-old man presenting with insufficiency fracture of proximal tibia associated with unrecognized osteoporosis. Radiologic bone DEXA (Dual Energy X-ray Absorptiometry) assessment revealed osteoporosis, but the patient displayed no apparent risk factors for insufficiency fractures and osteoporosis except for a history of smoking. Following right proximal tibial open reduction and internal fixation, the patient commenced smoking cessation and began taking alendronate.The patient was treated for gait rehabilitation, which included quadriceps strengthening exercises and his condition improved with independent walking. This report highlights an unusual site of proximal tibial insufficiency fractures and the potential effect of smoking on low bone mineral density in a young male patient.