Impact of Traumatic Events and Resilience on the Professional Quality of Life among Clinical Nurses / 재활간호학회지

PURPOSE: This study was to determine the impacts of traumatic events and resilience on the professional quality of life (ProQoL) among clinical nurses. METHODS: In this cross-sectional correlational descriptive study, 325 nurses completed questionnaires of traumatic events, resilience, and ProQoL consisted of compassion satisfaction (CS) and compassion fatigue (CF). Data were analyzed by Spearman correlation analysis and hierarchical regression. RESULTS: Traumatic events positively correlated with CF. Resilience positively correlated with CS and negatively correlated with CF. In this study, multivariate analysis showed that traumatic events and resilience explained 24% of the variance in CS and 7% of the variance in CF. CONCLUSION: A nursing education to enhance resilience and recognition of CS and CF from stressful work-related traumatic events may benefit to improve the professional quality of life for clinical nurses.

Relationship among Emotional Clarity, Maternal Identity, and Fetal Attachment in Pregnant Women with Gestational Diabetes Mellitus

PURPOSE: The purpose of this study was to examine the relationship among emotional clarity in emotional intelligence, maternal identity, and fetal attachment to measure how emotional clarity and maternal identity impact on fetal attachment and to determine mediating effects of maternal identity in pregnant women at the time of diagnosis with gestational diabetes mellitus (GDM). METHODS: This study used a correlational survey design. 88 pregnant women with GDM completed a study questionnaire of emotional clarity, maternal identity, and fetal attachment immediately after the diagnosis of GDM. Data were analyzed Mann-Whitney U test, and ANOVA with Duncan test, Pearson correlation, three-step regressions to test mediating effect, and Sobel test. RESULTS: The emotional clarity was positively related with maternal identity and fetal attachment. It affected maternal identity with 21.9% of explained variance. The emotional clarity and the maternal identity were significant predictors of fetal attachment by 57.7% of explained variance. The maternal identity mediated the relationship between emotional clarity and fetal attachment. CONCLUSION: The results suggest that a nursing program to enhance the emotional clarity and the maternal identity needs to be developed as an effective strategy to improve fetal attachment.

Effects of 10% Lidocaine Spray and Aroma Hand Massage on Pain, Anxiety, Blood Pressure, and Pulse During Arteriovenous Fistula Needling in Hemodialysis Patients / 재활간호학회지

PURPOSE: To determine the effects of 10% lidocaine spray and aroma hand massage on pain, anxiety, blood pressure, and pulse during arteriovenous (AV) fistula needling in hemodialysis (HD) patients. METHODS: This study used a quasi-experimental design. Forty HD patients were assigned to either 10% lidocaine spray group (n=21) or aroma massage group (n=19). 10% lidocaine was sprayed 3 times around AV fistula 10 minutes before. Aroma hand massage was performed for 5 minutes with fluids containing 2% of lavender, peppermint, and geranium concentrate mixture. Pain, anxiety, blood pressure, and pulse were measured during AV fistula needling without any intervention on the first week and during interventions on the second week. Data were analyzed with χ² test, Fisher's exact test, t-test, paired t-test and MANCOVA. RESULTS: Pain and anxiety were significantly decreased in both the lidocaine spray group and aroma massage group. Aroma hand massage was more effective to reduce pulse during AV fistula needling. CONCLUSION: The results suggest that 10% lidocaine spray and aroma hand massage may be effective to reduce pain, anxiety, and pulse during AV fistula needling in HD patients.

Organizational Socialization and Intention to Leave in Operating Room Nurses Working at Secondary General University Hospitals / 간호행정학회지

PURPOSE: To evaluate the relationship between organizational socialization and intention to leave, and to identify factors affecting on intention to leave in operating room nurses. METHODS: This study used a descriptive design. Seventy operating room nurses recruited from three hospitals under the same management style, in-service educational system, and working conditions agreed to participate in this study, and completed self-administered questionnaires of the organizational socialization and the intention to leave questionnaire. Respondents were classified by career as advanced beginner, competent practitioner, proficient practitioner and expert practitioner by Benner's stages of nursing proficiency. Data were analyzed with t-test, ANOVA with multiple comparisons, Spearman correlation, and multiple regression analysis. RESULTS: Nurses unsatisfied with the current in-service continuous education had lower organizational socialization and higher intention to leave. In advanced beginners, job performance was lowest and organizational commitment was highest. In expert practitioners, intention to leave was highest. Organizational commitment, interpersonal relationship, identity and burnout were associated with intention to leave. Mutual trust, burnout, and interpersonal relationship were predictors of intention to leave explained 20.8% of variance. CONCLUSION: The career ladder program to enhance nurses' organizational socialization and intention to stay should be established and expanded for well-experienced operating room nurses.

Validation of the Korean version of the 39-Item Parkinson's Disease Questionnaire (PDQ-39)

PURPOSE: To evaluate the reliability and validity of the Korean version of the 39-item Parkinson's disease questionnaire (PDQ-39). METHODS: Cross-cultural adaptation was performed according to the international guidelines: forward and backward translation, focus group meeting, and a field test. With Korean consensus translation produced, validation was assessed by evaluating reliability and validity. Ninety-three outpatients with Parkinson's disease (PD) and 89 healthy aged controls were recruited. Internal consistency reliability was assessed by Cronbach's alpha. Validity was assessed by Spearman correlation analysis, t test, factor analysis, and analysis of variance with Duncan's multiple range tests. RESULTS: In the PD group, mean age was 65.13 +/- 9.84 years, and mean duration of PD was 42.41 +/- 37.01 months. Ceiling and floor effects ranged 1.1%-2.2% and 1.1%-15.1%, respectively. Cronbach's alpha of eight dimensions ranged from .70 to .97. All dimensions were correlated with each other, except for the stigma dimension. PD patients had significantly lower quality of life than healthy aged controls did, except for the bodily discomfort dimension. Eight dimensions of Korean PDQ-39 loaded on one factor. PD patients with a Modified Hoehn and Yarh Staging score of 4 had the worst quality of life. The relationships among the eight dimensions of Koran PDQ-39 and the Modified Hoehn and Yarh Staging is fair to good, except for the stigma and social support dimension. CONCLUSION: The Korean PDQ-39 was proved to be reliable and valid. Our results suggest that Korean PDQ-39 could be used in clinical research to assess and evaluate the disease process and its impacts on health-related quality of life in Korean PD patients.

Effects of a Case Management Program on Self-efficacy, Depression and Anxiety in Pregnant Women with Gestational Diabetes Mellitus

PURPOSE: To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. METHODS: Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test. RESULTS: The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group. CONCLUSION: The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.

Factors associated with Lower Urinary Tract Symptoms for Patients with Parkinson's Disease

PURPOSE: The study was done to identify lower urinary tract symptoms (LUTS) and to evaluate the factors affecting LUTS for the people with Parkinson's disease. METHODS: The research design was a cross-sectional study with interviews using a structured questionnaire. The participants were 72 patients with Parkinson's disease who were seen in the Neurology clinic of a university hospital from September to November 2005. RESULTS: Mean score of LUTS for the participants was 10.11. In each symptom score of LUTS (range 0-5), weak stream was the highest 2.06, followed by nocturia 1.71, and urgency 1.61. The severity of LUTS was moderate to severe group for 51%. LUTS were significantly different by regular exercise. Positive correlations were observed between Hoehn and Yahr stage (stage of disease severity) and frequency and between Hoehn and Yahr stage and urgency (r=.280, p=.018; r=.328, p=.005). LUTS were significantly predicted by regular exercise (p=.001) which explained 15.0% of the variance in LUTS. CONCLUSION: Regular exercise was found to be a very important factor associated with LUTS for patients with Parkinson's disease.

Validation of the Korean Version of Liver Disease Quality of Life (LDQOL 1.0) Instrument / 대한간학회지

BACKGROUND/AIMS: Assessment of Health-related quality of life (HRQOL) outcomes in treatment of chronic disease is increasingly important. The objective of this study was to validate a Korean translation of the Liver Disease Quality of Life instrument (LDQOL version 1.0) for use in patients with chronic liver disease. METHODS: Two native Korean speakers with fluent English translated LDQOL including instructions, items, and response choices. This Korean translation of the LDQOL was administered to 121 patients with chronic liver disease. Cronbach's alpha coefficients were applied to test an internal consistency reliability of disease-specific scales of the LDQOL. MELD and modified CTP scores were calculated for all patients. Associations of MELD and modified CTP scores with severity of liver disease were analyzed with LDQOL. RESULTS: Internal consistency reliability was good (Cronbach's Alpha=0.69-0.94) in liver disease specific scales, except for the quality of social interaction scale (Cronbach's Alpha= 0.56). Mean modified CTP score and MELD score were 6.2+/-1.9 and 9.3+/-5.3, respectively. Both MELD score and modified CTP score showed correlations with most of the scores of liver disease specific scales of LDQOL 1.0, except for the quality of social interaction and sleep scale. CONCLUSIONS: The Korean version of the liver disease specific scales of the LDQOL 1.0 is validated and useful for measuring HRQOL in Korean patients with chronic liver disease.

Body Fat Distribution and Blood Pressure according to Anthropometric Change in Korean Patients with Non-Insulin Dependent Diabetes Mellitus(NIDDM) / 간호학회지

PURPOSE: This study was done to identify fat distribution and blood pressure according to anthropometric change patterns between NIDDM patients and control subjects. METHODS: Cross-sectionally 167 NIDDM patients and 87 controls were studied. Previous maximal body weight and acute weight loss was obtained. Current height, body weight, BMI, waist-hip ratio(WHR), skinfold thicknesses(abdomen, subscapular and triceps), and blood pressure was measured. Three anthropometric change patterns were categorized by BMI changes from the maximum lifetim's BMI to the current time (obese-obese, obese-nonobese and nonobese-nonobese: obese: BMI > or =25 kg/m2, nonobese: BMI<25 kg/m2). The data was analyzed by chi-square, t-test, age adjusted ANCOVA and Least Squares Means(LSM) for multiple comparison. RESULT: Acute body weight loss(p=0.01), anthropometric change types (p=0.001), WHR (P=0.05), and skinfold thickness (p=0.002) of NIDDM were significantly higher than those of the controls. The mean arterial pressure, WHR and skinfold thicknesses were greater in both obese-obese and obese-nonobese NIDDM and control subjects compared with both nonobese-nonobese NIDDM and control subjects. (all p's<0.05). CONCLUSION: NIDDM patients had more central and upper body adiposicity. Also both obese-obese and obese-nonobese NIDDM and control subjects had higher mean arterial pressures and central body obesity.

Current Status of Health-related Quality of Life Research in Korea / 대한류마티스학회지

OBJECTIVE: This paper reviews the existing Korean medical, nursing and public health academy articles on health-related quality of life, and provides recommendations for the universally validated core quality of life instruments and for wide use of these measures in clinical trials widely. METHODS: A comprehensive review of 116 Korean articles from www.richis.org was conducted. A review of the application, Korean validation, and publishment of Western quality of life instrument from www.QOLID.org. and Medline was conducted in the 116 Korean academic articles. RESULTS: 1. The journal search yielded a total 116 articles, of which 81 were published in Korean nursing academic journal, 35 in medical and public health journals 2. The 4 generic instruments were developed in Korea (1 for middle-aged adult in Seoul, 1 for geriatrics, Korean Quality of Life Scale, Catholic Medical Center Health Survey). The instrument for Korean middle-aged adult was used in 50 Korean articles, but the deletion of items and domains, and change of response scales without conceptual considerations showed. 3. The Korean articles used Western Instruments were 43, of which 13 used generic instruments, 24 used disease-specific, and 2 used domain-specific instruments. 4. The translated instruments in Korean were 4 instruments of COOP-chart, Ferrans and Powers Quality of Life Index-Generic version (QLI), Medical Outcomes Study (MOS) 12-Items Short Form (SF-12), Medical Outcomes Study (MOS) 36-Items Short Form (SF-36) among 33 kinds of quality of life instrument from www.QOLID.org. There was no evidence of publishment internationally on Medline searching. The Korean version of Euro-Qol (EQ-5D) instrument is going on the publishment. 5. Thirteen studies out of 116 Korean articles reported the use of Western Instrument including QLI, WHQOL, General Health Questionnaire (GHQ), COOP-C, COOP-WONCA, Nottingham Health Profile (NHP) and SF-36 among 33 generic quality of life instruments in Korean academic articles. The ommission of international validation step, deletion of items and domains, change of response scales without cultural adaptation and conceptual considerations showed in Korean studies used Western instruments. CONCLUSION: To use the health outcomes instruments universally and to perform multi-national studies, it is suggested that cross-cultural equivalence across all translated versions and conceptual equivalence of translated instruments to the original version must be verified and the quality of life assessment need to be applied to clinical trials.

Current Status of Disease-specific and Domain-specific Health-related Quality of Life Research in Korea / 대한류마티스학회지

OBJECTIVE: This paper reviews the existing Korean medical and public health, and nursing academy articles on disease-specific and domain-specific quality of life, and provides recommendations for the universally validated core quality of life instruments and for use of these measures in clinical trials widely. METHODS: Quality of Life Instruments Database (QOLID) was searched in order to identify all relevant disease-specific, population-specific, and domain-specific QOL instruments. Titles and abstracts of 27 articles related to QOL research conducted by Korean researchers were retrieved from MEDLINE and RICH database. These articles were comprehensively reviewed to analyse the cross cultural adaptation, validation and other aspects of application of Korean version of QOL measures. RESULTS: 1. The journal search yielded a total 27 disease-specific and domain-specific articles, of which 22 were published in Korean nursing academic journal, 5 in medical and public health journals 2. Search for QOLID resulted in 92 specific QOL measures. Thirty-six instruments of which 31 were disease-specific measures, 2 symptom-specific, 2 population-specific, and 1 domain-specific, were translated into Korean language among them. Four Korean version of specific QOL measures were used in articles in MEDLINE. They were Health Assessment Questionnaire (HAQ), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Childhood Health Assessment Questionnaire (CHAQ), and Child Health Questionnaire (CHQ). An article using Korean version of Fibromyalgia Impact Questionnaire (FIQ) is in press. 3. The Korean validated instruments published at international academic articles were HAQ, WOMAC, CHAQ, and CHQ. 4. The Korean version of Parkinson's Disease Questionnaire (PDQ), Kidney Disease Quality of Life Instrument (KDQOL), Functional Assessment of Cancer Therapy (FACT), Functional Assessment of Anorexia/Cachexia (FACTT), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT- F), Functional Assessment of Spiritual Wellbeing (FACT-Sp), and FACT-Anemia are going on Korean validation and data collection under the author contact and permission. 5. Twenty six studies out of 27 Korean articles reported the use of 16 kinds of Western instrument. There were some flaws such as omission of validation steps, deletion of items, arbitrary change of response scale, and absence of cultural adaptation and conceptual consideration in those articles. CONCLUSION: To use the health outcomes disease-specific instruments universally and to perform multi-national studies, it is suggested that cross-cultural equivalence across all translated versions and conceptual equivalence of translated instruments to the original version must be verified and the quality of life assessment need to be applied to clinical trials.

The Effects of Guided Imagery on Nursing Students Performing Intramuscular Injections / 간호학회지

PURPOSE: The anxiety and stress of nursing students on performance intramuscular injection diminished nursing skill performance. The purpose of this study was to identify the effects of the guided imagery program on anxiety, stress and nursing skill performance of nursing students. METHOD: The study design was time series with a nonequivalent control group pretest- posttest study. The Data were collected from the 30th of Oct. to the 6th of Nov. 2001. The objects of this study were 36 sophomores of university(18 for the experimental group, 18 for the control group). The Instruments used in this study were State Trait Anxiety Inventory developed by Spielberger (1972), Visual Analogue Scale for Stress and Nursing skill performance developed by the researcher. The guided imagery was provided through audiotapes to the subjects for 8 minutes. The pretest was given before the therapy to measure variables for both groups and the posttests were performed after intervention. The data were analyzed by the SAS program using t-test and paired t-test. RESULT: The results of this study are as follows. The level of anxiety of students who received the guided imagery were significantly lower than that of control group. the level of stress had a deeling tendency and the nursing skill performance level was significantly higher than that of control group. CONCLUSION: The guided imagery suggested as an effective nursing intervention did reduce the anxiety and promoted nursing skill performance of nursing students.

Past and Present Obesity, Parameters of Body Fat and Blood Pressure in Korean Patients with Non-Insulin Dependent Diabetes Mellitus (NIDDM) / 간호학회지

PURPOSE: To determine the frequency of past and present obesity among patients with NIDDM and to identify the differences of body fat, blood pressure and C-peptide/glucose ratio according to obese diabetic patients (BMI> or =25 kg/m2) and nonobese (BMI<25 kg/m2). Also the final factor is to observe the anthrometric change patterns in the study. METHOD: The weight at 20 years-old, previous maximal body weight, and acute weight loss were queried. Current height, body weight, BMI, waist & hip circumferences, waist-hip ratio, skinfold thicknesses, blood pressure, fasting blood glucose, and fasting C-peptide were measured in one hundred sixty-seven NIDDM patients. The differences of the parameters ccording to obese and nonobese, and three anthropometric change patterns were analyzed. RESULT: Results were as follows: 1. 66.5 % of the NIDDM patients had a history of past obesity as assessed by their maximum weight, while only 33.2% of them were currently obese (p's < 0.001). 2. The waist & hip circumferences, skinfold thicknesses, systolic, diastolic & mean arterial blood pressure in obese patients were greater than those of nonobese patients (all p's < 0.001). 3. The waist and the hip circumferences, and skinfold thicknesses (subscapula & triceps) were highest among the obese-obese group. WHR and abdominal skinfold thickness in the obese-obese and obese-nonobese groups were higher than those in the nonobese- nonobese group. Systolic & diastolic and mean arterial blood pressures in the obese-obese group were higher than those of obese-nonobese and nonobese-nonobese groups (all p's < 0.005).4. The abdominal and subscapular skinfold thicknesses in female diabetic patients were greater than those of male patients (all p's <0.0001). CONCLUSION: Although most Korean NIDDM patients were previously obese, many of them were not obese during the course of the study. Greater central and upper body adiposicity and higher blood pressure was shown in obese diabetic patients. Also, greater central and upper body adiposicity was demonstrated in female diabetic patients.

The Effect of Hypertonic Dialysate on Hemodynamic Parameters (blood pressure, pulse rate, ultrafiltration rate), Interdialytic Weight Gain and the Incidence of Thirst with Hemodialysis Patients / 성인간호학회지

Hemodialysis(HD)-associated hypotension is a frequent complication, but it is difficult to manage. Until now, several maneuvers have been tried to prevent the HD-associated hypotension. Of these, the sodium content of dialysate was regarded as an important factor for maintaining blood pressure during HD. In this study, we evaluated the effect of hypertonic dialysate on blood pressure, interdialytic weight gain and the incidence of thirst. The study was done for 6 weeks successively with 3 different groups. Each patient was dialysed with 3 different dialysates for 2 weeks: Group I(Conventional HD: sodium concentration: 137 mEq/L), Group II(Hypertonic HD: 147 mEq/L) and Group III (Sequential HD: from 147 to 140 mEq/L). Hemodynamic parameters(blood pressure, pulse rate and ultrafiltration rate), biochemical parameters(hematocrits, blood urea nitrogen, creatinine, osmolality, sodium, potassium, chloride, fasting blood sugar) and complications (interdialytic weight gain &thirsty sensation) were compared among 3 groups. The results were as follows: 1. Decline of systolic blood pressure and diastolic blood pressure at the time of a 3 hour check during hemodialysis was lower in the Group II than Group I and III (p=0.002; p=0.012). and decline of diastolic blood pressure at the time of a 4 hour check during hemodialysis was lower in the Group II and III than Group I(p=0.04). 2. ncidence of hypotensive episodes during dialysis was significantly lower in Group II than group I (p=0.0287). 3. The ultrafiltration in Group III at the time of 1 hour, 2 hour and 3 hour check during hemodialysis was higher than that in Group I and II at the time of 1 hour, 2 hour and 3 hour check during emodialysis respectively (p=0.0001; p=0.0001; p=0.0004). 4. Interdialytic weight gain was higher in Group II(3.1+/-0.8) than GroupI(2.8+/-0.8) and III (2.9+/-0.9) (p=0.0422). 5. Hematologic and biochemical results were not significantly different among 3 Groups. 6. Frequency of thirst was different in Group I, II and III, 0.05+/-0.12, 0.41+/-0.24 and 0.22+/-0.29 respectively (p=0.0259). The results suggest that hypertonic HD was effective in preventing HD-associated hypotension but interdialytic weight gain and thirst sensations were increased as compared with a conventional method. In this situation, sequential HD seems to be an alternative method to minimizes the side effect of hypertonic HD.

The Effect of Positioning with Mechanically Ventilatory Acute Respitatory Failure Patients on Arterial Oxygen Partial Pressure and Alveolar-arterial Oxygen tension / 성인간호학회지

It is widely recognized that manipulation of body position takes advantage of the influences of gravity for improving oxygenation. The study aims to determine the effects of positioning(supine, prone, right lateral decubitus and left lateral decubitus positions) applied to the mechanically ventilatory acute respiratory failure patients on arterial oxygen partial pressure(PaO2), alveolar arterial oxygen tension difference(AaDO2), mean aterial pressure, peak inspiratory pressure and plateau pressure. Thirty two acute respiratory failure patients admitted to the medical intensive care unit at Kangnam St. Mary's Hospital, The Catholic University of Korea from March 1997 to January 1998, were divided into three groups by radiographic evidence of unilateral or bilateral lung disease. In group 1 with dominant right lung disease were twelve subjects, group 2 with dominant left lung disease had eight subjects and group 3 had twelve subjects with bilateral lung disease. The variables were measured in 30 minutes after each position of supine, prone, good lung down lateral decubitus and sick lung down lateral decubitus position. The position order was done at random by Latin squre design. The results are as follows; 1) With group 1 patients, the PaO2 in the left lateral decubitus and prone position were 126.8+/-30.8 mmHg and 106.7+/-36.8 mmHg, respectively(p=0.0001). 2) With group 2 patients, the PaO2 in the prone and the right lateral decubitus position were 121.7+/-44.7 mmHg and 118.5+/-31.7 mmHg, respectively (p=0.0018). 3) With group 3 patients, the PaO2 was 143.6+/-36.6 mmHg in the prone position (p=0.0001). 4) With group 1 patients, the AaDO2 in the left lateral decubitus and the right lateral decubitus position were 178.1+/-29.7 mmHg and 233.1+/-24.4 mmHg, respectively(p=0.0001). 5) With group 2 patients, the AaDO2 in the prone and the left lateral decubitus postion were 184.0+/-39.5 mmHg and 231.0+/-23.9 mmHg, respectively(p=0.0019). 6) With group 3 patients, the AaDO2 in the prone and the supine postion were 377.1+/-35.6 mmHg and 435.7+/-13.1 mmHg, respectively (p=0.0001). 7) There were no differences among the mean arterial pressure, peak inspiratory pressure and plateau pressure for each of the supine, prone, left lateral decubitus and right lateral decubitus position. The results suggest that oxygenation may improve in mechanically ventilatory patients with unilateral lung disease when the position is good lung dependent and prone, and patients with bilateral lung disease when the position is prone without any effects on the mean arterial pressure and airway pressure. It is suggested that body positions improve ventilation/perfusion matching and oxygenation need to be specified in patient care plans.

The Study of Serum lipid Profile and Food Behaviors in Healthy Offsprings of Korean NIDDM Patients

This study was to investigate the risk factors for the development of diabetes mellitus on healthy offsprings of Korea non-insulin dependent diabetes mellitus(NIDDM) patients. Forty four offsprings who have at least 1 parent with NIDDM and age, sex and body mass index(BMI) matched forty four healthy control subjects were collected for this study. BMI, skinfold thickness, waist/hip circumference ration(WHR), fasting blood glucose, serum insulin, serum lipid profile, nutrient intakes and food behaviors were measured. There were no significant difference in BMI, WHR, fasting blood glucose, insulin, total cholesterol, triglyceride and daily nutrients intake between offsprings and controls. But skinfold thickness, LDL-cholesterol level and sweety food eating frequency were significantly higher in male offsprings than in male controls. And HDL-cholesterol was significantly lower in male offsprings than in male controls. Although there were no significant difference, offsprings had a overeating habit and ate more confectionery and greasy food than controls.

A Comparison of Pain Reducing Effects of Topical EMLA Cream and Subcutaneous Lidocaine in Hemodialysis Patients / 기본간호학회지

This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as 4.56+/-1.38 and 2.05+/-1.36 points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%) and pallor(5 cases, 6.3%) were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27 cases, 16.9%) and fear for needle insertion (6 cases, 3.8%). The most frequent problems with EMLS cream application were an inconvenience in use (11 cases, 6.9%) and tedious long pretreatment time (11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.