Empathy With Patients and Post-Traumatic Stress Response in Verbally Abused Healthcare Workers

Objective@#The current study examined the differential empathic capacity, post-traumatic symptoms, and coping strategies in healthcare workers (HCWs) according to the exposure of verbal or physical workplace violence (WPV). @*Methods@#Using online survey, a total of 422 HCWs employed at a training general hospital of South Korea participated and completed self-reporting questionnaires including the WPV questionnaire with coping strategy, the Jefferson Scale of Physician Empathy. @*Results@#Those who experienced either only verbal violence or both physical and verbal violence had lower Jefferson Scale of Physician Empathy scores (p<0.05). Posttraumatic stress symptom severity was higher among people who experienced verbal violence than physical violence. HCWs’ exposure to verbal violence was associated with severe posttraumatic symptoms and a low level of empathy with patients (p<0.05). More than half of the victims of verbal violence responded that they did not take any action, receive organizational protection, or peer support, while most physically-abused HCWs received institutional intervention or help from others. @*Conclusion@#Our findings highlight the critical importance of reducing verbal violence, which may represent a larger psychological burden compared to physical violence, by actively implementing effective strategies and policies at the institutional level.

Empathy With Patients and Post-Traumatic Stress Response in Verbally Abused Healthcare Workers

Objective@#The current study examined the differential empathic capacity, post-traumatic symptoms, and coping strategies in healthcare workers (HCWs) according to the exposure of verbal or physical workplace violence (WPV). @*Methods@#Using online survey, a total of 422 HCWs employed at a training general hospital of South Korea participated and completed self-reporting questionnaires including the WPV questionnaire with coping strategy, the Jefferson Scale of Physician Empathy. @*Results@#Those who experienced either only verbal violence or both physical and verbal violence had lower Jefferson Scale of Physician Empathy scores (p<0.05). Posttraumatic stress symptom severity was higher among people who experienced verbal violence than physical violence. HCWs’ exposure to verbal violence was associated with severe posttraumatic symptoms and a low level of empathy with patients (p<0.05). More than half of the victims of verbal violence responded that they did not take any action, receive organizational protection, or peer support, while most physically-abused HCWs received institutional intervention or help from others. @*Conclusion@#Our findings highlight the critical importance of reducing verbal violence, which may represent a larger psychological burden compared to physical violence, by actively implementing effective strategies and policies at the institutional level.

Burnout as a Mediator in the Relationship between Work-Life Balance and Empathy in Healthcare Professionals

Objective@#This cross-sectional study aimed to 1) explore the relationships among work-life balance (WLB), burnout, and empathy and 2) investigate the roles of the subtypes of burnout relating to WLB and empathy. @*Methods@#A total of 105 health care professionals from a general hospital in Seoul were assessed using the Maslach Burnout Inventory, Jefferson Scale of Physician Empathy, and a one-sentence-question on subjective WLB. Multiple questions on psychiatric problems, including sleep problems, anxiety, depressive symptom, and alcohol problems, were also included. @*Results@#In the mediation analyses, personal achievement was considered as a potential mediating variable between WLB and empathy. The direct effect (β=3.93, 95% CI: 1.21–6.64) and the indirect effect (β=1.95, 95% CI: 0.52–3.76) of WLB on empathy were also significant. @*Conclusion@#Interventions encouraging personal achievement may help mitigate burnout of health professionals.

A Study on Factors Affecting Suicidal Tendency of the Elderly Living Alone on Care Services

OBJECTIVES: The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. METHODS: A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. RESULTS: The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). CONCLUSIONS: We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

Effects of Extracorporeal Shockwave Therapy in Chronic Stroke Patients With Knee Osteoarthritis: A Pilot Study

OBJECTIVE: To evaluate the effects of extracorporeal shockwave therapy (ESWT) on pain, function, and ultrasonographic features of chronic stroke patients with knee osteoarthritis (OA). METHODS: A total of 18 chronic stroke patients (33 knee joints) with unilateral or bilateral knee OA (Kellgren-Lawrence grade ≥1) were enrolled in this study. The patients were randomly allocated to an experimental group receiving ESWT (n=9) or a control group receiving sham ESWT (n=9). For the ESWT group, patients received 1,000 pulses weekly for 3 weeks, totaling to an energy dose of 0.05 mJ/mm² on the proximal medial tibia of the affected knee. The assessments were performed before the treatment, immediately after the first treatment, and 1 week after the last treatment using the following: the visual analog scale (VAS) for pain; patient perception of the clinical severity of OA; the Korean version of Modified Barthel Index (ambulation and chair/bed transfer); the Functional Independence Measure scale (FIM; bed/chair/wheelchair transfer, toilet transfer, walking, and stairs); and ultrasonographic features (articular cartilage thickness, Doppler activity, and joint effusion height). RESULTS: The experimental group showed a significant improvement in VAS score (4.50±1.87 to 2.71±1.38) and patient perception of the clinical severity of OA (1.87±0.83 to 2.75±0.46). The bed/chair/wheelchair transfer components of the FIM score also improved significantly (4.12±1.55 to 4.62±1.30). In terms of the ultrasonographic features, increased Doppler activity was observed in the medial knee in the experimental group immediately following ESWT. CONCLUSION: It is suggested that ESWT may reduce pain and improve function in chronic stroke patients with OA, and may increase vascular activity at the target site.

Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Molecular Targeting of ERKs/RSK2 Signaling Axis in Cancer Prevention

RSK2 is a downstream signaling protein of ERK1 and ERK2 and plays a key role in physiological homeostasis. For this reason, RSK2 is a highly conserved protein among the p90RSK family members. In its location in the signaling pathway, RSK2 is a kinase just upstream of transcription and epigenetic factors, and a few kinases involved in cell cycle regulation and protein synthesis. Moreover, activation of RSK2 by growth factors is directly involved in cell proliferation, anchorage-independent cell transformation and cancer development. Direct evidences regarding the etiological roles of RSK2 in cancer development in humans have been published by our research group illustrating that elevated total- and phospho-RSK2 protein levels mediated by ERK1 and ERK2 are higher in skin cancer tissues compared to normal skin tissues. Notably, it has been shown that RSK2 ectopic expression in JB6 Cl41 cells induces cell proliferation and anchorage-independent cell transformation. Importantly, knockdown of RSK2 suppresses Ras-mediated foci formation and anchorage-independent colony growth of cancer cells. Kaempferol is a one of the natural compounds showing selectivity in inhibiting RSK2 activity in epidermal growth factor-induced G1/S cell cycle transition and cell transformation. Thus, ERKs/RSK2 signaling axis is an important target signaling molecule in chemoprevention.

Internal Fixation Using Clavicle Hook Plates for Distal Clavicle Fractures

BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.

Surgical Treatment of Using Acutrak Screw for Ankle Medial Malleolar Fracture / 대한족부족관절학회지

PURPOSE: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. MATERIALS AND METHODS: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. RESULTS: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. CONCLUSION: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

Peroneus Longus Dislocation associated with Trimalleolar Fracture: A Case Report / 대한족부족관절학회지

Traumatic dislocation of the peroneus longus tendon is an often unrecognized injury which has been reported to occur most commonly during sports activity. Most acute cases with early detection can be treated by simple repair of the tendon or retinaculum using one of several procedures available. Accurate treatment through a comprehensive evaluation of the ankle injury prevents suboptimal and sometimes unrecorrectable outcomes. The authors experienced concomitantly the peroneus longus tendon dislocation associated with a trimalleolar fracture of the ankle. We report this case a brief review of the literature.

The Current Trends and Problems of Aromatherapy

There is a fast increasing interest in the use of aromatherapy among medical professionals. This is not only because aromatherapy has become popular due to the limits of the conventional medicine but also because medical doctors are suffering from certain problems in the medical insurance. This is why the author is tying to explain the therapeutic effects of aromatherapy and to correct the widespread fantastical beliefs on the basis of evidences and author's experiences. Conclusively, the main effects of aromatherapy are antimicrobial, psychotropic, and immune-stimulant.

The Current Trends and Problems of Aromatherapy

There is a fast increasing interest in the use of aromatherapy among medical professionals. This is not only because aromatherapy has become popular due to the limits of the conventional medicine but also because medical doctors are suffering from certain problems in the medical insurance. This is why the author is tying to explain the therapeutic effects of aromatherapy and to correct the widespread fantastical beliefs on the basis of evidences and author's experiences. Conclusively, the main effects of aromatherapy are antimicrobial, psychotropic, and immune-stimulant.

Evaluation of leukoreduction filter Bio R02 plusTM for packed RBC / 대한수혈학회지

BACKGROUND: As universal WBC filtration of RBCs prior to storage is currently under consideration, few data are available on the performance of WBC-reduction filtration in routine practice. The pre-leukodepletion is thought to minimize the incidence of transfusion associated adverese effects such as HLA alloimmunization, non-hemolytic febrile reactions, platelet refractoriness, transfusion associated graft versus host disease and transmission of infections. The aim of this study was to evaluate the one of pre-storage and bedside leukocyte removal filter, leukocytes Bio R02 plusTM (Fresenius HemoCare, Germany) for packed RBCs. METHODS: In order to evaluate leukocyte removal filter of leukocytes Bio R02 plusTM, thirteen units of red blood cells were prepared and filtered using Bio R02 plusTM, and were measured the WBC count, RBC count, volume, sodium, and pH before and after filtration, respectively and the reduction power of white blood cell and biochemical changes in red blood cell units were analysed. RESULTS: There were 99.99% reduction in WBC counts, residual leukocyte content of 0.06 +/- 0.08 106 per unit and 8.69% of RBC loss after filtration, and there was no difference in the sodium and pH. CONCLUSION: The leukocyte removal filter Bio R02 plusTM showed sufficient leukocyte removal and RBC recovery efficiency for RBC units.