BACKGROUND: Many of the major life events that appear to affect biologic system and health occur within the context of the family and can have a profound psychosocial and biologic impact on family memebers. So, the present study attempted to examine the relations of family function with stressful life events, depression, and physical and psychological symptoms reported by patients. METHODS: Design : Cross sectional, observational study. Participants : 41 healthy adult males from a family medicine ambulatory care unit in a tertiary hospital located in Guro completed a series of psychometric instruments that include the Family APGAR(Adaptation, Partnership, Growth, Affection, and Resolve), FACESIII(Family Adaptability and Cohesion Evaluation Scale), Modified 46-item Stressful Life Events Scale, Lee's 98 items Stressful Life Event Scale, Korean version of BEPSI(Brief Encounter Psychosocial Instrument) and BDI(Beck's Depression Inventory Scale). RESULTS: Family APGAR was negatively correlated with stress related life events(both in total and negative events, -0.30, -0.37, respectively; p<0.05) and BEPSI(-0.56; p<0.0001). No significant correlation could be found between family function and positive life events. Family APGAR also revealed significant negative correlation with BDI(-0.61; p<0.0001). Among the three family types, severe dysfunctional family demonstrated highest level of stressful life events score, perceived stress, and depression(p<0.05). CONCLUSIONS: The higher the assessment of the family function(Family APGAR), the lower the level of stressful life events, perceived stress and depression. There, knowledge of the family function, stress, and coping could be useful to family physicians in the whole person approach of their patients.
Adult* ; Ambulatory Care ; Depression* ; Humans ; Male* ; Observational Study ; Physicians, Family ; Psychometrics ; Tertiary Care Centers

No abstract available.

No abstract available.
Humans ; Infant*

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

Caring for a patient dying is a hardship not only for the health care professionals, but also for the direct family members. Everyone wants to die in peace. However, inevitable problems accompanied by pain, dyspnea, moist breathing, nausea and vomiting, restlessness jerking and twitching were commonly noted in the last phase of life. Terminal patients also experience increasing weakness and immobility, loss of interest in food and drink, difficulty in swallowing, and drowsiness during the last hours of life. Control of symptoms and family support are extremely important, and the actual nature of the primary illness takes less importance. This is a time when levels of anxiety, stress, and emotion can be high for patients, families, and other caregivers. Thus, it is important for the healthcare team to adopt sensitive and systematic approach to patients including documentation and communication of end-of-life issues. Hospice is the most ideal program for this purpose.
Anxiety ; Caregivers ; Deglutition ; Delivery of Health Care ; Dyspnea ; Hospices ; Humans ; Nausea ; Patient Care Team ; Psychomotor Agitation ; Respiration ; Sleep Stages ; Vomiting

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.
Chronic Disease ; Dementia ; Eligibility Determination ; Heart ; Hospice Care ; Hospices ; Humans ; Korea ; Liver Diseases ; Lung ; Palliative Care ; Practice Guidelines as Topic ; Stress, Psychological

Kabuki make-up syndrome (KMS) was firstly reported in 1981 by Niikawa, et al. and Kuroki et al. in a total of ten unrelated Japanese children with characteristic array of multiple congenital anomalies and mental retardation. The name reflects the resemblance between the facial features of patients and the actors of Kabuki, one of the most famous traditional performing arts in Japan. The syndrome is characterized by mental and developmental retardations and peculiar facial features including long palpebral fissures with eversion of the lateral portion of lower eyelid and arching of eyebrows. In addition, dermatoglyphic and skeletal abnormalities are commonly associated. In Japan, the syndrome appears to have an incidence of about 1 : 32,000 newborns. Outside of Japan, a growing number of patients have been recognized. However, this syndrome has been reported only a few cases in Korea. We report a boy diagnosed by clinical features with a brief review of the literature.
Asian Continental Ancestry Group ; Child ; Dermatoglyphics ; Eyebrows ; Eyelids ; Humans ; Incidence ; Infant, Newborn ; Intellectual Disability ; Japan ; Korea ; Male

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.
Heel ; Humans ; Infant, Newborn ; Male ; Parturition ; Skin

Chronic pain is associated with disabling physical and emotional symptoms. Patients with chronic pain utilize more health services, have an impaired sense of well-being and frequently experience anxiety or depression. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life. Treatment of chronic pain involves a comprehensive approach using medication and functional rehabilitation. The usual approach for mild to moderate pain is to start with nonopioid analgesics. Also, trying antidepressant drugs for sleep loss and gabapentin for neuropathic pain or fibromyalgia is appropriate. For moderate to severe chronic pain, opioid analgesics can be used without any serious side effects if adequately used at the right dosage. It is important to provide guidance on the safe use of analgesics and other psychoactive drugs. Dosing of acetaminophen should be limited to avoid liver toxicity, and topical analgesics are preferred for focal pain. Full-dose nonsteroidal anti-inflammatory drugs should not be used for more than short periods, in order to avoid gastrointestinal, renal, and cardiovascular complications. Mechanisms of analgesia, drug selection, and recommendations for clinical usage for the management of chronic pain are reviewed in this paper.
Acetaminophen ; Amines ; Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Antidepressive Agents ; Anxiety ; Chronic Pain ; Cyclohexanecarboxylic Acids ; Depression ; Fibromyalgia ; gamma-Aminobutyric Acid ; Health Services ; Humans ; Liver ; Neuralgia ; Psychotropic Drugs ; Quality of Life

PURPOSE: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. METHODS: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) > or =10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. RESULTS: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. CONCLUSION: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.
Advance Directives ; Anti-Bacterial Agents ; Cross-Sectional Studies ; Enteral Nutrition ; Glasgow Coma Scale ; Hospices ; Humans ; Korea ; Life Support Care ; Medical Records ; Palliative Care ; Parenteral Nutrition, Total