The purpose of this study was to develop the basis of scientific nursing intervention by examining the changes of stress level with elapse of post chemotherapy in breast cancer patients. The design of this study was a longitudinal descriptive study. The subjects of this study was patients receiving chemotherapy from March 1, 1998 to June 30, 1998 at K university hospital in Taegu. The number of subjects was 14 and they were given treatment every 21 days, a cycle of chemotherapy. The changes of their stress with the elapse of chemotherapy were examined every other day. The changes of stress reaction were measured by fatigue and salivary cortisol level. The instrument used to measure fatigue was the revised Pipe Fatigue Scale which was developed by Piper(1984). The reliability of this instrument was Cronbach's alpha .997. The Salivary cortisol was meausured to examine the stress physiological reaction, analyzed using radioimmunoassay. Data was analyzed by computer using the SPSS WIN 7.0 program. Frequency, and Wilcoxon Singned Ranks test were used to examine the changes in degree of fatigue and salivary cortisol with the elapse of chemotherapy. The relationship between fatigue and salivary cortisol was examined using Spearman's rho. The results of this study were as follows: 1) The degree of fatigue was increased a little on the third day 5.64( +/- 1.86)(z=-1.85, p=.06) compared with that of fatigue on the basic day. After that, the degree of fatigue was continuously decreased. it had tendancy to increase a little as patients visited the clinic for next chemotherapy. 2) The mean of salivary cortisol concentration was the higest shortly before chemotherapy. 3) The relationship of fatigue and salivary cortisol was r= .4(p=.098). To sum up, the degree of fatigue was the highest on the third day and salvary cortisol was the highest shortly before chemotherapy. Because the stress reaction of cancer patient receiving chemotherapy was the higest within 3 days in one cycle, it will be effective to provide specified nursing interventions to reduce stress within 3 days after chemotherapy.
Breast Neoplasms* ; Breast* ; Daegu ; Drug Therapy* ; Fatigue* ; Humans ; Hydrocortisone* ; Nursing ; Radioimmunoassay

No abstract available.
Adolescent* ; Humans ; Love*

PURPOSE: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. MATERIALS AND METHODS: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age 34.7+/-15.4 yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. RESULTS: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe (24~26%) thalami (21~22.4%), parietal and occipital lobe (< or =10%). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former 4.7+/-1.5 and the latter 3.2+/-1.4 in G1, 5.0+/-1.1 and 4.8+/-1.2 in G2, 6.8+/-1.8 and 6.3+/-1.1 in G3, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. CONCLUSION: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.
Brain Injuries* ; Brain* ; Equidae* ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Occipital Lobe ; Perfusion ; Psychometrics ; Rabeprazole ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

The purpose of this study is to investigate the effects of doxapram on the rates of spontaneous and neostigmine-induced recovery from neuromuscular block with vecuronium and atracurium. Following intravenous injection of either vecuronium (40 patients) or atracurium (40 patients), recovery index (RI) was measured without administering either doxapram or neostigmine (Group 1), or after administration of a combination of neostigmine 40 ug/kg and doxapram 1 mg/kg (Group 2), neostigmine 40 ug/kg (Group 3) or doxapram 1 mg/kg (Group 4) when twitch tension returned to 25% block of train of four response, each of the four group had 10 patients. The results were such that RI was significantly prolonged after vecuronium in the presence of doxapram compared with Group 1 (13.5 min vs 8.2 min). There was no significant difference in the RI after atracurium in the presence of doxapram compared with Group 1 (7.0 min vs 7.1 min). There was rapid recovery which was significant when neostigmine was administered with or without doxapram (2.4 min vs 2.3 min respectively after vecuronium; 2.3 min vs 2.4 min respectively after atracurium). The authors conclude that administration of doxapram in situation where neuromuscular block with vecuronium is not adequately antagonized does not contribute to rapid recovery from neuromuscular block.
Atracurium* ; Doxapram* ; Humans ; Injections, Intravenous ; Neostigmine ; Neuromuscular Blockade ; Vecuronium Bromide*

OBJECTIVES: Sharing of cancer-related information among healthcare professionals is crucial to ensuring the quality of long-term care for cancer survivors. Appropriate distribution of the essential facts can be achieved using data models. The purpose of this study was to develop and validate suitable data models for use in the nursing assessment of cancer survivors. METHODS: The models developed in this study were based on a modification of concept analysis developed by Walker and Avant. Our approach involved determining the purpose of the analysis, identifying data elements, defining these elements and their uses, determining critical attributes, value sets, and cardinalities, and ultimately constructing data models which were examined externally by domain experts. RESULTS: We developed 112 data models with 112 data elements, 29 critical attributes, 102 value sets, and 6 data types for the assessment of cancer survivors. External validation revealed that the data elements, critical attributes, and value sets proposed were comprehensive, relevant, and sufficiently useful to encompass nursing issues related to cancer survivors. CONCLUSIONS: Data models developed in this study will contribute to ensuring the semantic consistency of data collected from cancer survivors, which will improve the quality of nursing assessments and in turn translate to improved long-term patient care.
Delivery of Health Care ; Electronic Health Records ; Humans ; Long-Term Care ; Nursing Assessment ; Patient Care ; Quality of Health Care ; Semantics ; Standard of Care ; Survivors

No abstract available.
Blood Pressure* ; Body Mass Index*

Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence(69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001). The greatest impact was on movement(83.5%), followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture byssocausis(55%). The conclusion: Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, expecially by gender and by age.
Adult ; Aged* ; Arm ; Chronic Pain ; Drug Therapy ; Female ; Hobbies ; Humans ; Knee ; Leg ; Male ; Medicine, East Asian Traditional ; Neck ; Pain Management ; Quality of Life ; Surveys and Questionnaires ; Shoulder

PURPOSE: The purpose of this study was to identify the specific types and characteristics of gender role identity in view of male nursing students. METHOD: Q-methodology, a technique for extracting subjective opinions, was used. Forty participants completed the Q-sort activity, rating each statement relative to the others. The Q sample has two categories, representing masculinity and femininity, and each category has 20 statements, resulting in 40 adjectives. The collected data were analyzed by QUANL PC program. RESULTS: Three types of gender role identity of male nursing students were identified: 'Taciturn warmth type', 'assertive power type', 'empathic warmth type'. Despite the differences among the types in this research, male nursing students are likely to have the understanding and keep faith. CONCLUSION: Male nursing students were exposed to many problems because of the gendered culture of nursing education. To understand the male nursing students' gender role identity will help to promote adaptation in nursing field.
Education, Nursing ; Femininity ; Gender Identity* ; Humans ; Male ; Masculinity ; Nursing ; Q-Sort ; Students, Nursing*

PURPOSE: The purpose of this study was to evaluate the applicability of the evidence based guideline for prompted voiding by Lyons & Specht (2001) in National Guideline Clearinghouse(TM) for use in Korea based on the experts' opinions. METHOD: The target expert group consisted of 8 registered nurses, 6 physicians, and 5 nursing professors who are experts in urinary incontinence. This study used a questionnaire survey. The appropriateness, applicability, and the present application of each recommendation in the guideline were analyzed with descriptive statistics using the SPSS program, with content analysis based on the experts' opinions. RESULT: The scores on each recommendation's appropriateness showed the high degree of agreement among nurses, physicians, and nursing professors. However, the recommendation for 'use of oxybutinin' showed the lowest score as 5.89. It was notable that the most recommendations scored lower for applicability compared with appropriateness. The reasons for lower scores for applicability were the lack of clinicians' knowledge of assessment and management, and the lack of resources in clinical settings in Korea. CONCLUSION: This study will augment the understanding of the actual urinary incontinence management in Korean clinical settings and can be used as the baseline data for further study of tailoring international guidelines into local and national clinical settings.
Korea* ; Nursing ; Urinary Incontinence

A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scar along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated an unusual linear increased uptake along the midline of the upper abdomen that corresponded to the skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.1) Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.2) It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.2) Siddiqui et al3) suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.
Abdomen ; Cicatrix ; Fever ; Gastrectomy* ; Hematoma ; Humans ; Keloid* ; Male ; Middle Aged ; Neoplasm Metastasis ; Physical Examination ; Radionuclide Imaging ; Skin ; Stomach Neoplasms ; Technetium Tc 99m Medronate* ; Wounds and Injuries