PURPOSE: This study aimed to evaluate the psychometric properties of the Depression Anxiety Stress Scales 21 and 12 in a Korean population. METHODS: The Depression Anxiety Stress Scales were translated into Korean using a translation and backtranslation technique, and the content validity was assessed by an expert panel. Participants were recruited from six community health centers (n = 431) and two community mental health centers (n = 50). A field test of the psychometric properties of the instruments was conducted using confirmatory factor analysis with bootstrap maximum likelihood estimation involving 1,000 samples, Pearson's analysis, t test, and Cronbach's α coefficient. RESULTS: Confirmatory factor analysis of the Depression Anxiety Stress Scales 21 and 12 supported both three-factor and second-order three-factor models. The Scales 21 and 12 satisfied convergent validity with the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Perceived Stress Scale-10 and discriminant validity with the Rosenberg Self-Esteem Scale. The scores for the Depression Anxiety Stress Scales 21 and 12 were higher for the psychiatric group than for the nonpsychiatric group, confirming the presence of known-groups validity. The Depression Anxiety Stress Scales 21 and 12 exhibited moderate-to-strong correlations with the Negative Affect. Cronbach's a coefficients for the Depression Anxiety Stress Scales 21 and 12 were .93 and .90, respectively. CONCLUSION: The Depression Anxiety Stress Scales 21 and 12 appear to be acceptable, reliable, and valid instruments. However, the shorter Depression Anxiety Stress Scales 12 may be more feasible to use in a busy practice and also be less burdensome to respondents.
Anxiety ; Community Health Centers ; Community Mental Health Centers ; Depression ; Humans ; Psychometrics ; Surveys and Questionnaires ; Weights and Measures

PURPOSE: Metastatic biliary tract cancer (mBTC) has a dismal prognosis. In this study, an independent dataset of patients with mBTC was used to implement and validate a routine clinico-laboratory parameter-based scoring model for risk group identification. MATERIALS AND METHODS: From September 2006 to February 2015, 482 patients with mBTC were assigned randomly (ratio, 7:3) into investigational (n=340) and validation datasets (n=142). The continuous variables were dichotomized using a normal range or the best cutoff values determined using the Contal and O'Quigley statistical methods. Following a Cox’s proportional hazard model, the scoring model was derived by summing the rounded chi-square scores for the factors identified by multivariate analysis. RESULTS: The performance status (Eastern Cooperative Oncology Group 3-4), hypoalbuminemia (< 3.4 mg/dL), carcinoembryonic antigen (≥ 9 ng/mL), neutrophil-to-lymphocyte ratio (≥ 3.0), and carbohydrate antigen 19-9 (≥ 120 U/mL) were identified as independent prognosticators (Harrell’s C index, 0.682; integrated area under the curve, 0.653). Survival was clearly correlated with the risk groups (low, intermediate, and high, 14.0, 7.3, and 2.3 months, respectively; p < 0.001). The prognosis was also discriminative in the validation data set (median survival, 16.7, 7.5, and 1.9 months, respectively; p < 0.001). Chemotherapy did not offer any survival benefits for high-risk patients. CONCLUSION: These proposed prognostic criteria for mBTC can facilitate accurate patient risk stratification and treatment-related decision-making.
Biliary Tract Neoplasms* ; Biliary Tract* ; Carcinoembryonic Antigen ; Dataset ; Drug Therapy ; Humans ; Hypoalbuminemia ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Reference Values ; Social Identification

No abstract available.
Xanthogranuloma, Juvenile*

Porokeratosis is a group of genetic diseases characterized by clonal proliferation of keratinocytes. We report a 16-year-old female who presented with both linear porokeratosis and disseminated superficial actinic porokeratosis. The unusual coexistence of these two types of porokeratosis is an example of a type 2 segmental manifestation of an autosomal dominant skin disorder.
Adolescent ; Female ; Humans ; Keratinocytes ; Porokeratosis* ; Skin

PURPOSE: Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS: cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS: The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R2 values, the final model accounted for 20.0% of the variance in selfefficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS: This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*nursing/*psychology ; Female ; *Health Knowledge, Attitudes, Practice ; *Health Literacy ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Quality of Life/*psychology ; Republic of Korea ; Self Care/*psychology ; *Self Efficacy ; Surveys and Questionnaires ; Young Adult

No abstract available.

PURPOSE: This study was to identify the effect of the experience of diabetes education on knowledge, self-care behavior and glycosylated hemoglobin (HbA1C). Further, this study was held to examine about patient's preferred methods of education and re-education frequency. METHODS: 166 type 2 diabetes patients from two hospitals in Incheon participated in this study. Data were analyzed by using descriptive analysis, t-test, ANOVA, Scheffe's test and multiple regression analysis. RESULTS: 72.3% patients needed re-education and the average interval of re-education was 8.53 months. Patients preferred education methods were lectures, practical training, and studying from pamphlet. Depending on the frequency of diabetes education, there were significant differences in the level of diabetes knowledge (F=10.88, p<.001) and self-care behaviors (F=4.59, p=.012), but there was not significant difference with HbA1C (F=1.53, p=.220). As to how much the diabetes education helped managing diabetes, there was a significant difference in the level of self-care behaviors (t=2.01, p=.049), but there were not significant differences in level of knowledge (t=1.10, p=.275) and HbA1C (t=-.33, p=.746). The experience of diabetes education was a significant factor which influenced patient's knowledge (t=3.93, p<.001) and self-care behaviors (t=2.21, p<.001). But HbA1C was not influenced by the experience of diabetes education (t=-1.68, p=.096). CONCLUSION: It is necessary to provide diabetes education with appropriate interval and methods and subjects that reflect the needs of patient through the study results.
Education* ; Hemoglobin A, Glycosylated* ; Humans ; Incheon ; Lectures ; Pamphlets ; Self Care*

OBJECTIVES: The aim of the present study was to investigate gender difference in empathic ability and recognition of facial emotion expression in schizophrenic patients. METHODS: Twenty-two schizophrenic outpatients (11 men and 11 women) and controls (10 men and 12 women) performed both the scale of Empathic Quotient (EQ) and facial emotion recognition test. We compared the scores of EQ and the facial emotion recognition test among each group according to diagnosis and gender. RESULTS: We found a significant sex difference in the scores of EQ and the facial emotion recognition test in the schizophrenic patients. And there were significantly negative correlation between the score of the facial emotion recognition test and the scores of Positive and Negative Symptom Scale (PANSS) in female schizophrenic patients. However, in male schizophrenic patients, there were no significant correlations between the score of each test and the scores of PANSS. CONCLUSIONS: This study suggests that the sex difference in empathic ability and facial emotion recognition would be very important in chronic schizophrenic patients. Investigation of sex effects in empathic ability and facial emotion recognition in chronic schizophrenic patients would present an important solution for constructing optimal rehabilitation program.
Diagnosis ; Empathy ; Female ; Humans ; Male ; Outpatients ; Rehabilitation ; Schizophrenia ; Sex Characteristics

The point prevalence of atopic dermatitis (AD) among Korean adults visiting the Health Service Center for health check-ups was assessed. AD was diagnosed based on the questionnaires filled by patients and through physical examination by dermatologists. A total of 3,563 persons completed the questionnaires, and 2,032 persons were examined by the dermatologists. According to the questionnaires, the prevalence of AD was 7.1%, and from the dermatologists' examination, it was 2.6% overall, which decreased with age significantly. The prevalence in men was higher than that of women. Grading the severity of AD according to their eczema area and severity index scores, 70.6% were classified as being mild, 25.5% moderate, and 3.9% severe. Interestingly, concomitance of psoriasis and AD was found in 0.5% of those examined by the dermatologists. Our results suggest that AD is one of the most common skin diseases not only in children but also in adults in Korea.
Adult ; Age Factors ; Aged ; Dermatitis, Atopic/complications/diagnosis/*epidemiology ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; Prevalence ; Psoriasis/complications ; Questionnaires ; Republic of Korea/epidemiology ; Severity of Illness Index ; Sex Factors

PURPOSE: Equations are frequently used to estimate resting energy expenditure (REE) in a clinical setting. However, few studies have examined their accuracy in end-stage renal disease (ESRD) patients. PATIENTS AND METHODS: To investigate agreement between indirect calorimetry and several REE estimating equations in 38 ESRD patients on peritoneal dialysis, we performed indirect calorimetry and compared the results with REEs estimated using 5 equations [Harris-Benedict (HBE), Mifflin, WHO, Schofield, and Cunningham]. RESULTS: Measured REE was 1393.2 +/- 238.7kcal/day. There were no significant differences between measured and estimated REEs except Mifflin (1264.9 +/- 224.8kcal/day). Root mean square errors were smallest for HBE, followed by Schofield, Cunningham, and WHO, and largest for Mifflin (171.3, 171.9, 174.6, 175.3, and 224.6, respectively). In Bland-Altman plot, correlation coefficients between mean values and differences were significant for HBE (r=0.412, p=0.012) and tended to be significant for Cunningham (r=0.283, p=0.086). In DM patients and patients with overhydration, HBE showed significant underestimation when REE increased. CONCLUSION: In ESRD patients on continuous ambulatory peritoneal dialysis (CAPD), REE-estimating equations have no significant differences from indirect calorimetry, except Mifflin. However, HBE showed greater bias than others when REE was high.
Adolescent ; Adult ; Calorimetry, Indirect/*methods ; *Energy Metabolism ; Female ; Humans ; Kidney Failure, Chronic/metabolism/*therapy ; Male ; Middle Aged ; Models, Biological ; Peritoneal Dialysis, Continuous Ambulatory/*methods