The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson's Disease

OBJECTIVE: To explore whether the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) can be used to screen for dementia or mild cognitive impairment (MCI) in less educated patients with Parkinson's disease (PD). METHODS: We reviewed the medical records of PD patients who had taken the Korean MMSE (K-MMSE), Korean MoCA (K-MoCA), and comprehensive neuropsychological tests. Predictive values of the K-MMSE and K-MoCA for dementia or MCI were analyzed in groups divided by educational level. RESULTS: The discriminative powers of the K-MMSE and K-MoCA were excellent [area under the curve (AUC) 0.86–0.97] for detecting dementia but not for detecting MCI (AUC 0.64–0.85). The optimal screening cutoff values of both tests increased with educational level for dementia (K-MMSE < 15 for illiterate, < 20 for 0.5–3 years of education, < 23 for 4–6 years, < 25 for 7–9 years, and < 26 for 10 years or more; K-MoCA < 7 for illiterate, < 13 for 0.5–3 years, < 16 for 4–6 years, < 19 for 7–9 years, < 20 for 10 years or more) and MCI (K-MMSE < 19 for illiterate, < 26 for 0.5–3 years, < 27 for 4–6 years, < 28 for 7–9 years, and < 29 for 10 years or more; K-MoCA < 13 for illiterate, < 21 for 0.5–3 years, < 23 for 4–6 years, < 25 for 7–9 years, < 26 for 10 years or more). CONCLUSION: Both MMSE and MoCA can be used to screen for dementia in patients with PD, regardless of educational level; however, neither test is sufficient to discriminate MCI from normal cognition without additional information.

A Study on the Factors Affecting Resilience in Patients with Colon Cancer

PURPOSE: The purpose of this study was to identify the level of resilience, social support, depression, anxiety and self-efficacy in patients with colon cancer, and to examine factors affecting resilience. METHODS: Data were collected from 121 patients who had been diagnosed with colon cancer, at the 'B' hospital in Gyeonggi province and 'J' hospital in Jeju from October 30th to November 20th in the year of 2012. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffe's test, Pearson correlation coefficients and stepwise multiple regression in SPSS WIN 18.0 program. RESULTS: The level of resilience significantly differed by occupation, average monthly household income, education level and existence of stoma. Resilience had significant positive correlation with family members support, friends supports, medical staff support and self-efficacy. Resilience had a significant negative correlation with anxiety and depression. Factors affecting resilience were education level, existence of stoma, friends supports, anxiety and depression with R2 value of 65.9%. CONCLUSION: Measures to improve the resilience of colon cancer patients are needed as well as nursing intervention that includes social support such as medical staff support. Education level, existence of stoma, anxiety and depression should also be taken into account.

Moyamoya Syndrome in a 42-Year-Old Man With Down Syndrome

No abstract available.

Development and Evaluation of "Hospice Smart Patient" Service Program

PURPOSE: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. METHODS: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. RESULTS: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. CONCLUSION: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.