PURPOSE: This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. METHOD: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. RESULT: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second . CONCLUSION: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.
Aged ; Chronic Pain* ; Education ; Family Characteristics ; Female ; Humans ; Jurisprudence ; Nuclear Family ; Nursing ; Pain Management ; Program Development ; Quality of Life* ; Surveys and Questionnaires ; Spouses

PURPOSES: This study examined uncertainty and nursing need according to illness phases(phase I, II, III) in cancer patients, and investigated relationships between uncertainty and nursing need. METHODS: A cross-sectional descriptive study was conducted with a sample of 121 adult cancer patients treated in two hospitals. RESULTS: As for the total score, the uncertainty was not significantly different across the subgroups by illness phase. As for the subscale score, however, two sub-scales of the uncertainty were different across the subgroups. 'The unpredictability' was highest in illness phase I and II groups, while 'the lack of information' was highest in the illness phase III group. Nursing need as the total score was not significantly different across the subgroups by illness phase. However, all subscale scores of the nursing need were significantly different across the subgroups. Educational need was highest in the illness phase I group; physical and emotional needs were highest in the illness phase III group. Uncertainty and nursing need were not related to each other at any illness phase. CONCLUSION: The results suggest that nursing need and uncertainty may change across illness phases. Clinicians need to consider this pattern in caring for cancer patients.
Adult ; Humans ; Uncertainty

THE NECESSITY AND PURPOSE OF THE STUDY: Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. METHODS OF RESEARCH: Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. DATA COLLECTION: Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. DATA ANALYSIS: For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. RESULTS AND DISCUSSION: 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance
Anxiety ; Attention ; Chronic Disease ; Surveys and Questionnaires ; Delivery of Health Care ; Equipment and Supplies ; Hospital Administration ; Hospitals, General ; Humans ; Insurance, Health ; Korea ; Nursing ; Seoul ; Statistics as Topic

The purposes of this study were to describe systematically 18 years of oncology nursing research in Korea and suggest it's direction in future. 149 nursing studies published from 1980 to 1998 were selected for the present study. There were examined the source and the design of study, type of subjects, measurement variables, the intervention outcome of experimental research, and theme of qualitative research. The results were as follows : 1. 121 of 149 studies were composed of master thesis and dissertation of graduate school. There were 55 correlations, 30 descriptions, 19 comparisons, 19 qualitative studies and 2 Q-methods as the type of research design. 2. Cancer patients without describing specified diagnose as subjects' characteristic were 44 of total studies. The others had various diagnoses such as gastric cancer, uterine cancer, breast cancer, leukemia, Iymphoma, colorectal cancer, and lung cancer. According to treatment type. patients receiving chemotherapy were the highest number distribution as 53 of all researches. 3. Most measurement instruments used for research were translated it into Korean that developed by foreigners, such as Zung's depression. Spielberg's anxiety, and Wallston's locus of control. 4. Quality of life was shown the most frequently among correlational researches. the next one was depression the third was hope, and so on. 5. There was the most frequent comparison between cancer and non-cancer patients in comparative researches. It was surveyed those variables as diet habits, risk factors, stressful life events, anxiety and depression and self-care capacity between two groups. 6. The subjects were mostly chemotherapy Patients as 15 of 24 experimental studies. Oral care and education were respectively the highest experimental interventions. 7. Qualitative researches about cancer were reported since 1991. Their themes were illness experience, adaptation process, dying experience, family experience, hope. caring, experience of health behavior, meaning of chemotherapy and experience of cancer survivor. Phenomenologic methodology was designed above 50% of qualitative researches. According to the above findings, cancer research had increased since 1990 and done mostly by descriptive design but a few experimental studies. As recommendations for the future, It is necessary to study the comparison of oncology nursing research internationally. the replication to establish the effect of nursing intervention and the family care of cancer patient.
Anxiety ; Breast Neoplasms ; Colorectal Neoplasms ; Depression ; Diagnosis ; Drug Therapy ; Education ; Emigrants and Immigrants ; Food Habits ; Health Behavior ; Hope ; Humans ; Internal-External Control ; Korea ; Leukemia ; Lung Neoplasms ; Nursing ; Oncology Nursing* ; Qualitative Research ; Quality of Life ; Research Design ; Risk Factors ; Self Care ; Stomach Neoplasms ; Survivors ; Uterine Neoplasms

BACKGROUND: The opioid sparing effect of low dose ketamine is influenced by bolus dose, infusion rate, duration of infusion, and differences in the intensity of postoperative pain. In this study, we investigated the opioid sparing effect of low dose ketamine in patients with intravenous patient-controlled analgesia (PCA) using fentanyl after lumbar spinal fusion surgery, which can cause severe postoperative pain. METHODS: Sixty patients scheduled for elective lumbar spinal fusion surgery were randomly assigned to receive one of three study medications (K1 group: ketamine infusion of 1 microg/kg/min following bolus 0.5 mg/kg, K2 group: ketamine infusion of 2 microg/kg/min following bolus 0.5 mg/kg, Control group: saline infusion following bolus of saline). Continuous infusion of ketamine began before skin incision intraoperatively, and continued until 48 h postoperatively. For postoperative pain control, patients were administered fentanyl using IV-PCA (bolus dose 15 microg of fentanyl, lockout interval of 5 min, no basal infusion). For 48 h postoperatively, the total amount of fentanyl consumption, postoperative pain score, adverse effects and patients' satisfaction were evaluated. RESULTS: The total amount of fentanyl consumption was significantly lower in the K2 group (474 microg) compared to the control group (826 microg) and the K1 group (756 microg) during the 48 h after surgery. Pain scores at rest or with movement, the incidence of adverse events and patient satisfaction were not significantly different among the groups. CONCLUSIONS: Low-dose ketamine at 2 microg/kg/min following bolus 0.5 mg/kg significantly reduced the total amount of fentanyl consumption during the 48 h after lumbar spinal fusion surgery without increasing adverse effects.
Analgesia, Patient-Controlled ; Fentanyl ; Humans ; Incidence ; Ketamine ; Pain, Postoperative ; Patient Satisfaction ; Skin ; Spinal Fusion

PURPOSE: The aim of this study is to evaluate the effective role of living-related liver transplantation (LRLT) on posttransplant linear growth in children. METHODS: Thirty six children were enrolled who received LRLT at Asan Medical Center from December, 1994 to February, 1999 and showed more than one-year postoperative survival. Mean height standard deviation score (zH) was analyzed according to medical records including heights during pretransplant and posttransplant follow-up periods. RESULTS: zH of total children showed significant linear growth after LRLT from -1.58 to 0.33 at 24 posttransplant month (p<0.05). zH in children under 6 years of age, to exclude the effect of adolescent linear growth spurt, showed increment in height (p<0.05). Linear growth of children with liver cirrhosis improved and that with fulminant hepatitis was matained same. While stunted children (mean zH=-2.30) achieved good catch-up growth after transplantation, children with normal growth remained same. Children with significant hepatic dysfunction after LRLT such as chronic rejection or posttransplant lymphoproliferative disorder showed retarded posttrasplant linear growth. There was no statistical difference according to the type of immunosuppressants. CONCLUSION: LRLT resulted in adequate or catch-up linear growth in children with acute, chronic and metabolic liver disease. Successful LRLT suggested to be a promising option not only in long term survival but also in normal linear growth.
Adolescent ; Child* ; Chungcheongnam-do ; Follow-Up Studies ; Hepatitis ; Humans ; Immunosuppressive Agents ; Liver Cirrhosis ; Liver Diseases ; Liver Transplantation* ; Liver* ; Lymphoproliferative Disorders ; Medical Records

PURPOSE: Febrile urinary tract infection (UTI) is one of the commonest bacterial infections in children. The purpose of this study is to investigate the clinical characteristics of the first episode of febrile UTI occurring in children over 5 years compared to those in infants younger than a year. METHODS: We retrospectively reviewed the medical records of 10 patients over 5 years, having febrile UTI, and 25 controls under 1 year. Clinical characteristics including symptoms at admission, the time interval between symptom onset and hospital visit and/or diagnosis, duration of fever, urinalysis, and other laboratory and imaging test results were compared between the two groups. RESULTS: Most patients in the control group showed only high fever at the time of presentation to the hospital. However, 60% of the case group had fever along with gastrointestinal (GI) symptoms such as abdominal and flank pain, vomiting, as well as relatively mild pyuria. The case group showed a longer duration between symptom onset and hospital visit and/or diagnosis. CONCLUSIONS: Delay in diagnosis and initiation of treatment of UTI increases the risk of permanent renal scarring and associated complications. Therefore, early diagnosis and treatment of febrile UTI is vital for very young infants, as well as children considering that febrile UTI could be an important cause of febrile illness in children over 5 years.
Bacterial Infections ; Child ; Cicatrix ; Diagnosis ; Early Diagnosis ; Fever ; Flank Pain ; Humans ; Infant ; Medical Records ; Pyuria ; Retrospective Studies ; Urinalysis ; Urinary Tract Infections ; Vomiting

PURPOSE: To present the survival of consecutive patients with a minimum of three years follow-up after undergoing a metal-on-metal hip resurfacing arthroplasty. MATERIALS AND METHODS: Twenty hips from twenty patients (male: 16, female: 4) who underwent metal-on-metal resurfacing arthroplasty between October 2001 and April 2004 were followed up for at least 3 years. The mean patient age was 49 years (range 23~70), and the mean follow-up period was 56 months (range 36~84 months). A clinical evaluation was performed using the Harris hip score, and radiologic evaluation was performed regularly after surgery with plain radiographs. RESULTS: The mean Harris hip score improved from 46 points (range 73~32) preoperatively to 94 points at final follow-up. There were no cases of radiolucency or osteolysis around the stem or acetabular cup, and there was no migration of the acetabular or femoral component. The average femoral stem-shaft angle was 135degrees(range 121degrees- 139degrees), and at the final follow-up study, there was no change of the femoral stem. CONCLUSION: In the short-term, metal-on-metal resurfacing arthroplasty performed on the basis of bone quality and patient selection, showed excellent clinical and radiological results. Hip resurfacing is an attractive option for young patients fearing a potentially difficult future revision or for more active patients with hip disease.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Patient Selection

"Journal of Korean Academy of Adult Nursing" has been published since 1989 and more than 330 articles have been published up 2000. We reviewed all the articles published in this journal to analyze the contents and trend of published articles and to find out the way of improvement both in quantity and quality of studies in this area. The results are as follows; 1) Ninety percent of articles were quantitative studies. Experimental design was used in 16.1% and quasi-experimental design was adapted in 73.6% of articles. Qualitative research were 10.3% of total articles reviewed. 2) Only 5.1% of articles described theoretical framework and 73.6% of experimentally designed articles included research hypotheses. 3) Among experimental studies, only one was true experimental studie design. Eighty nine point three persent had descriptive survey method among non-experimental studies. Amog the thirty four qualitative studies, phenomenologic(73.5%), grounded theory(14.7%), and ethnographic (11.8%) design were used. 4) Most of research subject were patients and few healthy people, healthcare worker, and patient family. 5) Psychosocial data collection method which used questionnaire were 53.7% and interview, physical measurement, observation were used in 22.8%, 8.2%, 5.4% of articles respectively. 6) Total number of keywords were 692, and average number of key words per article was 2.2. Health-related keyword was the most frequently used according to four metaparadigm of nursing (human, health, nursing, and environment). Environment related keyword was rarely appeared. The number and quality of nursing research in "Journal of Korean Academy of Adult Nursing" have been improved continuously. It is difficult to find out special trend or characteristics which is unique in this journal because of relatively short history of adult nursing studies. This review study was performed to analyze adult nursing studies only in the view of quantitative aspect, but it is needed to analyse qualitatively to find philosophical or theoretical trend in nursing.
Adult* ; Surveys and Questionnaires ; Delivery of Health Care ; Humans ; Nursing Research* ; Nursing* ; Qualitative Research ; Research Design ; Research Subjects

Background/Aims: Sorafenib is the first approved systemic treatment for advanced hepatocellular carcinoma (HCC). However, its clinical utility is limited, especially in Asian countries. Several reports have suggested the survival benefits of hepatic arterial infusion chemotherapy (HAIC) for advanced HCC with main portal vein tumor thrombosis (PVTT). This study aimed to compare the efficacy of sorafenib-based therapy with that of HAIC-based therapy for advanced HCC with main PVTT. Methods: Advanced HCC patients with main PVTT treated with sorafenib or HAIC between 2008 and 2016 at Korea University Medical Center were included. We evaluated overall survival (OS), time-to-progression (TTP), and the disease control rate (DCR). Results: Seventy-three patients were treated with sorafenib (n=35) or HAIC (n=38). Baseline characteristics were not significantly different between groups, except the presence of solid organ metastasis (46% vs 5.3%, p<0.001). The median OS time was not significantly different between the groups (6.4 months vs 10.0 months, p=0.139). TTP was longer in the HAIC group than in the sorafenib group (2.1 months vs 6.2 months, p=0.006). The DCR was also better in the HAIC group than in the sorafenib group (37% vs 76%, p=0.001). Subgroup analysis, which excluded patients with extrahepatic solid organ metastasis, showed the same trends for the median OS time (8.8 months vs 11.1 months, p=0.097), TTP (1.9 months vs 6.0 months, p<0.001), and DCR (53% vs 81%, p=0.030). Conclusions HAIC-based therapy may be an alternative to sorafenib for advanced HCC with main PVTT by providing longer TTP and a better DCR.