Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients

PURPOSE: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. METHODS: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. RESULTS: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. CONCLUSION: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

Imaging Findings of Perineal Disease

The perineum is defined as the region of body below the pelvic diaphragm that lies within the boundaries of the pelvic outlet. It is the region which is home to pathologic conditions which include primary tumors, neoplasms of adjacent organs with secondary invo l vement, congenital or acquired cystic lesions and inflammatory lesions. In this article, we describe CT and MR imaging anatomy and various pathologic processes that affect this anatomic region, with a brief discussion. Emphasis is give n to imaging features that help to characterize specific lesions.

Epidemiological Study of Rubella Outbreak in Chungchungnam-Do in Middle and High School Students in a Local Small Town

BACKGROUND: Rubella is a viral infection of childhood. Its clinical manifestations are not serious, but rubella infection in early pregnancy can result. in congenital rubella syndrome. In Korea, there have been several rubella outbreaks in 1996. We performed an epidemiological study about a rubella outbreak in middle and high school students in an isolated small town. METHODS: This study was carried out from March 22, 1996 to April 29, 1996. The target populations were middle and high school students(middle school-1,369, high school-966 students) in Namseonri. They were given a questionnaire containing sociodemographic characteristics, past vaccination history and rubella-like symptoms. We selected 70 clinically diagnosed patients and 233 students with rubella-like symptoms from the questionnaires. Through IgM and IgG ELISA we analyzed the serum of selected students. All of the middle and high school students except those with clinical rubella were vaccinated on March 27. RESULTS: 1) The number of IgM positive students was 65 among 303 selected students. 58 students among the IgM positive group were diagnosed clinically, and 7 patients and subclincal infection. 2) Male patients were more predominant than female, especially in high school(M : F, 2 : 1 in middle school, 7 : 1 in high school). 3) Positive rates of IgG gradually increased by grade from 58.3% to 92.9% (1st grade of middle school to 3rd grade of high school). 4) IgG titer of the booster vaccinees(2nd and 3rd tirade female, high school) was significantly higher than younger female students(p<.05). 5) After mass vaccination, 3 more patients caught rubella in high school during 1 month follow-up. CONCLUSIONS: Among 2335 students, IgM positive patients were 65 with incidence rate of 2.8%. Mass vaccination of the studentg an effective preventive method in a rubella outbreak.

Case report on human infection of Hymenolepis diminuta

There has been no report on human infection of Hymenolepis diminuta in Korea until the first 3 cases were reported by our members after the identification of those eggs in stool in 1964. However, the distinct differentiation between H. diminuta and H. nana would often be difficult by the shape of eggs without adult worm. In 1965, authors found the additional case revealed the eggs in stool and succeeded to obtain three adult worms of H. diminuta from 10 years old boy in Pusan. The characteristic morphology of egg and adult worm were discussed to compare to those of H. nana. Conclusively, the first human infection of H. diminuta in Korea was reported after the identification both the eggs and adults worms