This study examined burdens of primary family carcgivcrs of paticnto with cerebrovascular accidents (CVA) along with related factors. In addition, their needs for support group intervention were assessed to develop a support group to reduce the burdens of caregiving. Eighty-one primary family caregivers of patients with CVAs at a general hospital in Seoul participated in this study . The patients with CVAs aged from 26 to 83 years with mean age of 63 years. About 90% of the patients had some paralysis and 56.6% suffered speech problems. Fifty-eight percent of the primary family caregivers were spouses of the patients and 80.2% were women. Primary family caregivers' burdens were assessed by the Burden Scale originally devel oped by Zarit (1980) and Novak & Geust(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financiaI burden. The results were as follows : 1. The average of burden score was 91.7, indicating moderate to severe level of burden. The time-dependent burden was scored highest followed by physical, developmental, social, financial, and emotional burdens. 2. of the characteristics of patients, age, gender, and severity of the disease were found to be associated with the level of burden. Of the characteristics of primary family caregivers, age and educational level were significantly related to the level of burden. Time of care since the CVA and the quality of relationship between a patient and a caregiver prior to the stroke were significant situational factors affecting the level of burden. 3. The need for support group intervention for the caregivero was very high (95.1%). The earcgivcrs of patients who had a CVA for the first time showed higher levels of need compared to those of patients who had a CVA more than once. The caregivers indicated a support group held once a month near home or hospital would be welcomed. In addition, they replied that a group composed of 9 to 10 caregivers and guided by health care professionals (e.g., physicians and nurses) would be most desirable. More than 85% of the earegivers identified the areas that they wanted intervention in as follows : knowledge, skills, and resources to care for a patient with a CVA. the counsel of health care professionals, share of their experiences with those who have similar situations, stress management skills, and methods to overcome emotional isolation due to the great responsibility for a patient. Given the results, support group is expected to be an effective way to reduce the burdens of primary family caregivers of patients with CVAs. As a follow up It is necessary to examine the effect of support group intervention on the patient's recovery and rehabilitation.
Caregivers* ; Delivery of Health Care ; Female ; Hospitals, General ; Humans ; Korea ; Paralysis ; Rehabilitation ; Self-Help Groups* ; Seoul ; Spouses ; Stroke*

Over the past decade, significant advances have been made in both the diagnosis and treatment of diabetic retinopathy. Ultrawide field fundus photography and spectral domain optical coherence tomography have allowed more accurate, convenient, and early diagnosis of diabetic retinopathy. Numerous randomized clinical trials have demonstrated the effectiveness of anti-vascular endothelial growth factor agents for the treatment of diabetic retinopathy, although more work is necessary in terms of long-term clinical outcomes and socioeconomic costs associated with these treatments.
Diabetic Retinopathy* ; Diagnosis* ; Early Diagnosis ; Endothelial Growth Factors ; Epidemiology ; Photography ; Tomography, Optical Coherence

PURPOSE:To compare macular thickness and visual acuity before and after panretinal photocoagulation in patients with severe diabetic retinopathy without diabetic macular edema. METHODS: Macular thickness and visual acuity (LogMAR) of 40 eyes were compared before and after panretinal photocoagulation, for severe diabetic retinopathy. Macular thickness was measured by optical coherence tomography(OCT). In addition, changes in macular thickness and visual acuity were compared with the patient's level of HbA1c, blood pressure, and diabetic nephropathy. RESULTS: Mean visual acuity before and 1.47+/-0.80 months after panretinal photocoagulation were 0.28+/-0.23 and 0.33+/-0.27, respectively, which was not a significant decrease (p=0.131). However mean central macular thickness (216.98+/-34.09 microm to 255.22+/-73.40 microm), and mean peripheral macular thickness (269.26+/-34.59 microm to 291.96+/-46.49 microm) did increase significantly after panretinal photocoagulation (p=0.001). The decrease of mean visual acuity and increase of mean macular thickness were greater in patients with high blood glucose, high blood pressure and diabetic nephropathy. CONCLUSIONS: In eyes with severe diabetic retinopathy treated with panretinal photocoagulation, mean visual acuity did not decrease significantly, but mean central and peripheral macular thickness significantly increased after treatment. We posit that visual prognosis after panretinal photocoagulation in eyes with severe diabetic retinopathy without macular edema is influenced by the control of blood glucose and blood pressure and the presence of diabetic nephropathy.
Blood Glucose ; Blood Pressure ; Diabetic Nephropathies ; Diabetic Retinopathy ; Eye ; Humans ; Hypertension ; Light Coagulation ; Macular Edema ; Prognosis ; Visual Acuity

We report a rare case of multicentric Castleman's disease that presented with ophthalmic involvement, along with a review of the literature. A 63-year-old male presented with decreased visual acuity in both eyes. Both eyes had serous elevations of the retinas with shifting subretinal fluid and annular choroidal detachment. No retinal breaks were found. Laboratory tests revealed pancytopenia, hypergammaglobulinemia, and an increased erythrocyte sedimentation rate. Chest and abdominal computed tomographies showed multiple lymphadenopathies in the mediastinum, abdomen, and in both inguinal areas. Histological examination of the inguinal lymph node biopsy was consistent with Castleman's disease. After combination chemotherapy, the serous elevations of both retinas and the annular choroidal detachments of both eyes disappeared. Ophthalmic involvement in Castleman's disease is very rare, and to the authors' knowledge, this is the first report of ophthalmic involvement of Castlemans's disease in Korea.
Aged ; Choroid Diseases/etiology ; Drug Therapy, Combination ; Exudates and Transudates/*metabolism ; Fluorescein Angiography ; Fundus Oculi ; Giant Lymph Node Hyperplasia/*complications/drug therapy ; Humans ; Hypergammaglobulinemia/complications ; Magnetic Resonance Imaging ; Male ; Syndrome ; Tomography, Optical Coherence ; Treatment Outcome ; Uveal Diseases/diagnosis/*etiology/*metabolism

Management of diabetic complications has been a worldwide major global health issue for decades. Recent studies from many parts of the world indicate improvement in this area. However, it is unknown if such an improvement is being realized in Koreans. Although there is limited information regarding diabetic retinopathy management among Koreans, recent epidemiologic studies have indicated improved screening rates and less frequent visual impairment among type 2 diabetics. Moreover, results achieved with new diagnostic and treatment modalities aimed to improve diabetic retinopathy management are encouraging for both physicians and patients.
Diabetes Complications ; Diabetic Retinopathy* ; Epidemiologic Studies ; Global Health ; Humans ; Mass Screening ; Vision Disorders

PURPOSE: To evaluate the efficacy of arteriovenous (AV) sheathotomy with internal limiting membrane peeling for persistent or recurrent macular edema after intravitreal triamcinolone injection and/or laser photocoagulation in branch retinal vein occlusion. METHODS: Twenty-two eyes with branch retinal vein occlusion (BRVO) with recurrent macular edema underwent vitrectomy with AV sheathotomy and internal limiting membrane peeling. All eyes had previous intravitreal triamcinolone injection and/or laser photocoagulation for macular edema. The best corrected visual acuity (BCVA), fluorescein angiography and optical coherence tomography (OCT) before and after surgery were compared. RESULTS: The mean preoperative BCVA (log MAR) were 0.79+/-0.29 and postoperative BCVA (log MAR) at 3 months was 0.57+/-0.33. And improvement of visual acuity > or =2 lines was observed in 10 eyes (45%). The mean preoperative fovea thickness measured by OCT was 595.22+/-76.83 micrometer (510-737 micrometer) and postoperative fovea thickness was 217.60+/-47.33 micrometer (164-285 micrometer). CONCLUSIONS: Vitrectomy with AV sheathotomy can be one treatment option for the patients with recurrent macular edema in BRVO.
Treatment Outcome ; Tomography, Optical Coherence ; Retrospective Studies ; Retinal Vein Occlusion/*complications/diagnosis/surgery ; Ophthalmologic Surgical Procedures/*methods ; Middle Aged ; Male ; Macular Edema, Cystoid/diagnosis/etiology/*surgery ; Macula Lutea/*surgery ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Female

PURPOSE: The purpose of this study was to investigate the level and factors influencing depression among nursing students. METHODS: The data were collected from nursing students attending 3 universities who expressed a willingness to participate in the study through a questionnaire which surveyed them about depression, stress, social support, self-efficacy, self-esteem, and wellbeing in May, 2012. The collected data from 235 nursing students were analyzed using a SPSSWIN 19.0. RESULTS: The mean score of depression (using MDI) among nursing students was 16.7, which denotes a minor depressive mood. 49.1% of variance with regard to depression among nursing students was explained by stress, self-esteem, wellbeing and self-efficacy. CONCLUSION: There is a need to develop a depression prevention program for nursing students and to reduce stress and increase self-esteem, wellbeing and self-efficacy in order to establish an effective program.
Depression* ; Humans ; Surveys and Questionnaires ; Students, Nursing*

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in self-efficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Aging ; Blood Pressure* ; Diet ; Education* ; Follow-Up Studies ; Humans ; Hypertension ; Nursing ; Obesity ; Self Care* ; Self Efficacy

PURPOSE: In order to improve self-management of elderly hypertensives in this study, the researcher examined the effect of blood pressure regulation by an abdominal relaxed breathing training which regulates physical response to stress and lessens the activity of the sympathetic nerve. METHOD: A quasi-experimental pre-test and post-test design was used. Thirty elderly hypertensive patient ; Sixteen in the abdominal breathing group and fourteen in the control group participated in this study. The abdominal relaxed breathing training consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. RESULT: 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of total stress response, physical stress response, behavioral-cognitive stress response between the experimental group and control group over three different times, and interaction by groups and over time. CONCLUSION: Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.
Aged* ; Blood Pressure* ; Humans ; Hypertension ; Nursing ; Respiration* ; Self Care

PURPOSE: The purpose of this study was to analyze the history of exposure to obscene material, and examine sexual attitudes and intercourse experience in order to develop an effective program for university students. METHOD: The data were collected in May, 2012 from 385 students attending 3 universities in Korea. An independent t-test and ANOVA were used to determine the differences with regard to sexual attitudes and intercourse experience according to general characteristics and history of exposure to obscene material. RESULTS: Sexual attitudes significantly differed according to timing of first exposure to obscene material (p<.001). Intercourse experience was significantly different according to timing of first exposure to obscene material (p=.016) and type of exposure to obscene material (p=.032). There was a negative correlation between first exposure to obscene material and sexual attitudes (p<.001), and a positive correlation between first exposure to obscene material and intercourse experience (p=.017). CONCLUSION: Results of this study indicate that history of exposure to obscene material should be considered as an important variable in managing the sexual health of university students.
Humans ; Korea ; Reproductive Health ; Sexual Behavior