PURPOSE: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. METHODS: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. RESULTS: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. CONCLUSION: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.
Diagnosis ; Education ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Quality of Life* ; Self Care* ; Stress, Psychological

PURPOSE: The purpose of this study was to systematically review the suicide prevention programs for healthcare personnel to identify contents, formats, and strategies essential for effective suicide prevention programs. METHODS: A systematic search using key words in English and Korean was conducted using 10 electronic databases, including EMBASE, MEDLINE, and RISS. Of 794 publications identified, 9 studies were finally included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for the quality assessment. RESULTS: Of the nine experimental studies, seven studies used randomized controlled trials (RCTs), and two used quasi-experimental designs. Overall, suicide prevention programs were found to be effective in improving competencies (e.g., knowledge, communication skills, and attitudes) of healthcare personnel working in diverse settings. Limitations of these studies included a lack of rigorous research designs and reliable and universal outcome measures. Paradoxically, none of the studies were conducted in South Korea, which consistently has the highest suicide rate of all OECD countries. CONCLUSION: Suicide prevention programs for health personnel can be an effective way to improve competency of healthcare personnel in preventing suicide. These findings will serve as a foundation for the development of suicide prevention programs by Korean healthcare personnel.
Delivery of Health Care* ; Health Personnel ; Humans ; Korea ; Organisation for Economic Co-Operation and Development ; Outcome Assessment (Health Care) ; Research Design ; Suicide*

Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.
Aged* ; Dental Porcelain ; Dental Prosthesis ; Female ; Health Care Costs ; Humans ; Tooth

Purpose: The present study was conducted to develop the Life Respect Enhancement Program and test its effectiveness on suicide knowledge, suicide intervention skills, self-efficacy in suicide prevention, and gatekeeper behaviors among nursing officers. Methods: The program was developed according to the ADDIE model and finalized after practical need analysis, expert verification, and a preliminary study.The present study used a concurrent embedded mixed-method research design. To compare the effects of the Program and the control group on the outcome variables, a quantitative study was conducted using a nonequivalent control group with a pretest-posttest design.Quantitative data were analyzed using c 2 -tests, t-tests, and RM-ANOVA. A qualitative study was conducted using FGI with six members of the experimental group 3 months after intervention completion. Results: In total, 56 nursing officers participated in the 3-month follow-up test. Compared to the control group, the experimental group showed significant improvements in suicide knowledge, suicide intervention skills, and self-efficacy in suicide prevention scores at post-test. The significant group differences in suicide knowledge and suicide intervention skills were maintained at 3 months. The gatekeeper behavior scores of the experimental group were also significantly higher than those of the control group at 3 months. Qualitative analysis of the participants’ experiences with the Program yielded two themes and seven sub-themes. Conclusion The newly developed Life Respect Enhancement Program demonstrates significant effects on suicide knowledge, suicide intervention skills, and gatekeeper behaviors. Thus, this program is recommended to promote suicide prevention competencies among nursing officers in military clinical settings.

Bell's palsy is an acute-onset unilateral peripheral facial neuropathy. For patients with sequelae of facial paresis, the successful rehabilitation of fully edentulous arches is challenging. This case report described the treatment procedures and clinical considerations to fabricate complete dentures of a patient who showed unilateral displacement of mandible, unilateral chewing pattern and parafunctional jaw movement due to sequelae of Bell's palsy. Gothic arch tracing was used to record reproducible centric relation and lingualized occlusion was performed to provide freedom to move between centric relation and the patient's habitual functional area in fabricating satisfactory dentures in terms of function and esthetics.
Bell Palsy ; Centric Relation ; Denture, Complete* ; Dentures ; Esthetics ; Facial Nerve Diseases ; Facial Nerve* ; Facial Paralysis ; Freedom ; Humans ; Jaw ; Mandible ; Mastication ; Paralysis* ; Rehabilitation*

Objectives: Recent studies have reported that delayed initiation of clozapine can affect clinical response in patients with treatment-resistant schizophrenia (TRS). This study aimed to explore the relationship between delayed initiation of clozapine and acute treatment response. Methods: Sixty-five inpatients with TRS who started clozapine for the first time were included through a retrospective chart review. Acute treatment response was defined as a 30% reduction in the Positive and Negative Syndrome Scale score or a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) at 4 weeks after initiating clozapine. Results: After meeting the TRS criteria, the mean delay for initiating clozapine was approximately 13.8 months. The delay was shorter in patients who showed a better response to clozapine in logistic regression analysis (p=0.037). Conclusion Our findings suggest that reducing the delay in initiating clozapine increases the effectiveness of clozapine in patients with TRS.

Objectives: Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods: This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results: Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia.

BACKGROUND: To minimize the inflammatory reaction and improve healing, a new modified dermal substitute composed of an atelocollagen, chondroitin-6-sulfate, and amniotic membrane (AM) was applied to full-thickness skin defects in a pig. Atelocollagen was extracted from bovine skin, and two modified dermal substitutes were generated according to the cross-linking type. METHODS: The AM-collagen dermal substitutes were characterized and compared with currently used dermal substitutes in a pig skin defect model. There were five experimental groups: dehydrothermal (DHT) cross-linking atelocollagen with the AM on the top (AM-DHT), DHT and chemical cross-linking atelocollagen with the AM on the top (AM-DHT/chemical), Terudermis, Integra, and AlloDerm. After 3x3 cm full-thickness skin defects on the back of a pig were created, each dermal substitutes dermal substitutes was randomly grafted on the defects. Two weeks after grafting, autologous partial-thickness skin was over-grafted on the neodermis. The take rate of the dermal substitutes, skin, and histological sections were all assessed at 1, 2, and 4 weeks postoperatively. RESULTS: More rapid healing and a higher take rate were evident in the AM-DHT and Terudermis groups. Histological examination revealed fewer inflammatory cells and more fibroblast hyperplasia in these two groups. Four weeks after surgery, the amount of newly formed collagen was significantly more appropriate in the AM-DHT group. CONCLUSIONS: These observations provide supporting evidence that a newly developed amniotic-collagen dermal substitute may inhibit inflammatory reactions and promote wound healing.
Amnion ; Biological Dressings ; Chondroitin Sulfates ; Collagen ; Dermis ; Fibroblasts ; Hyperplasia ; Skin ; Skin, Artificial ; Transplants ; Wound Healing

BACKGROUND: There are two variations in the attention subitem of the Mini-Mental State Exam (MMSE): 'serial 7's subtraction and "sam-chun-ri-gang-san" backward. At a scale of one to five, they can be used interchangeably, which inevitably brings a considerable difference in results. Thus, we compared the scores of the 'serial 7's subtraction' and the "sam-chun-ri-gang-san" backward and analyzed the influence of sociodemographic factors on the differences. METHODS: We administered the Korean MMSE including the two types of attention item: serial 7's and "sam-chun-rigang-san" backward to 239 community-dwelling elderly people aged 65 or older in Kyung Hee University Medical Center and four Seoul senior centers and analyzed the difference from June 2012 to July 2012. RESULTS: The score for "sam-chun-ri-gang-san" backward (2.5+/-2.1) was lower than that of the serial 7's (3.4+/-1.7) by a mean point of 0.9+/-1.9. The score of "sam-chun-ri-gang-san" backward was zero in 31.4% of the subjects. However, only 9.6% scored zero on the serial 7's. The ratio of the same scores between two tasks was 36.0%. Education was the primary source of variance on difference score, followed by the number of family. There was no significant effect of age or gender when the score of difference was analyzed by multiple regression. CONCLUSION: In this study, subjects tended to outperform the serial 7's in general. Upon administering "sam-chun-rigang-san" backward instead of serial 7's due to the preference of the patient, we should take into account that the score of "sam-chun-ri-gang-san" backward was 0.9 point (mean value) lower than serial 7's to ensure appropriate interpretation of MMSE score.
Academic Medical Centers ; Aged ; Education ; Humans ; Senior Centers ; Seoul

The purpose of this study was to predict osteoporosis risk as decreasing muscle mass and to declare the cut-off value of low muscle mass in an elderly Korean population. This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys (KNHANES). The subjects included 1,308 men and 1,171 women over 65 yr. Bone mineral density (BMD) and appendicular skeletal muscle (ASM) were measured by dual energy X-ray absorptiometry (DXA), and appendicular skeletal muscle was adjusted by height as a marker of sarcopenia. After confirming the correlation between low muscle mass and BMD, the best cut-off value of muscle mass to estimate osteoporosis was suggested through the receiver operating characteristic (ROC) curve. For both men and women, BMD correlated positively with low muscle mass when ASM/Ht2 was used as a marker for sarcopenia. The ROC curve showed that ASM/Ht2 was the best marker for osteoporosis at a cut-off value of 6.85 kg/m2 for men and 5.96 kg/m2 for women. When these cut-off values were used to determine sarcopenia, the risk of osteoporosis increased 4.14 times in men and 1.88 times in women. In particular, men (OR 2.12) with sarcopenia were more greatly affected than women (OR 1.15), even after adjusting for osteoporosis risk factors. In elderly Korean people, sarcopenia is positively correlated with BMD and there is a strong correlation between sarcopenia and osteoporosis with risk of bone fracture.
Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Area Under Curve ; Asian Continental Ancestry Group ; Body Mass Index ; Bone Density ; Female ; Humans ; Male ; Muscle, Skeletal/*pathology/radiography ; Nutrition Surveys ; Odds Ratio ; Osteoporosis/*diagnosis/etiology ; ROC Curve ; Republic of Korea ; Risk Factors ; Sarcopenia/physiopathology