Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis

PURPOSE: This study was conducted to construct and test a structural equation model of health-related quality of life (HRQoL) among hospitalized patients with pulmonary tuberculosis (PTB). METHODS: Participants were 256 patients with PTB who were 20 years or older and admitted in two national tuberculosis hospitals. The patients participated in pulmonary function testing and responded to structured questionaries. RESULTS: The goodness-of-fit statistics of the final hypothetical model were as follows: χ2/df=2.19, RMSEA=.07, SRMR=.05, GFI=.95, NFI=.95, CFI=.96, TLI=.92, and PCFI=.52. Symptoms and general health perception had significant direct effects, and subjective economic status, social support and stigma had significant indirect effect on HRQoL of hospitalized patients with PTB. These variables explained 64% of variance in the prediction model. CONCLUSION: Findings suggest that strategies and intervention for physical symptoms and depressive symptoms are crucial to improve the quality of life in hospitalized patients with PTB. The development of various social support programs is also recommended.

Influence of Stigma and Social Support on Depressive Symptoms in Hospitalized Patients with Pulmonary Tuberculosis / 정신간호학회지

PURPOSE: The aim of this study was to examine the relationships between depressive symptoms, stigma and social support in hospitalized PTB (pulmonary tuberculosis) patients. METHODS: Participants were 256 patients with PTB who were admitted in two national tuberculosis hospitals. RESULTS: Higher levels of stigma were significantly related to depressive symptoms in patients with PTB. Self-reports of social support by medical staff were negatively associated with depressive symptoms in patients with PTB. Stigma and social support by medical staff were found to be significant predictors of depressive symptoms after controlling for potential confounders. CONCLUSION: Findings suggest that intervention for depressive symptoms be incorporated into treatment for patients with PTB, and strategies to decrease TB-related stigma and increase social support by medical staff be provided to prevent depressive symptoms.

A Case of Cushing's Disease in Pregnancy

Developing Cushing's syndrome during pregnancy is rare because menstruation is irregular and hypercortisolism causes infertility. Developing Cushing's disease during pregnancy is very rare because there is even less ovulation than those with the adrenal adenoma. The clinical manifestations of Cushing's syndrome may easily be missed during pregnancy as the features of weight gain, hypertension, and hyperglycemia overlap with those that occur during a pregnancy. Diagnosing Cushing's syndrome during a pregnancy is complex because the biochemical features are obscured by the natural changes in the hypothalamic-pituitary-adrenal axis that occur during pregnancy. Having Cushing's syndrome during a pregnancy results in increased fetal and maternal complications, so early diagnosis and treatment are critical. We report the clinical and endocrine findings of a pregnant women with Cushing's disease who underwent transsphenoidal surgery after delivery.

A Study on the Relationship between Climacteric Symptom, Depression and Coping among Middle-Aged Women / 農村醫學 地域保健

OBJECTIVES: The purpose of this study were to examine the level of climacteric symptom, coping and depression among middle-aged women and to identify the relationship between climacteric symptom, coping and depression. METHODS: A descriptive correlational study was conducted. The participants were 275 middle-aged women visiting obstetrics and gynecology hospital in one metropolitan city. Data were collected using a self-administered questionnaire. Descriptive statistics, ANOVA and Pearson correlation were used for data analysis. RESULTS: The mean climacteric symptom score was .54, the mean depression score was .74 and the mean coping score was .35. The level of climacteric symptom, depression and coping were slightly lower than those of other studies. There were positive relationships between climacteric symptom and depression and between climacteric symptom and coping. CONCLUSIONS: To promote physical and emotional health of middle-aged women, more attention is necessary to decrease their climacteric symptom and depression. These results can be used for nursing intervention and care programs for creating better quality of life for middle-aged women.

Efficacy of Postoperative Patient Controlled Epidural Analgesia via the Lumbar Approach in Pediatric Patients Undergoing Lower Extremity Surgery / 대한정형외과학회잡지

PURPOSE: To evaluate the safety and efficacy of postoperative patient controlled epidural analgesia via the lumbar approach in children undergoing lower extremity surgery. MATERIALS AND METHODS: 40 patients between the ages of 5 and 12 years were randomly allocated into two groups; one group received conventional pain medications (intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n.) and the other group received patient controlled epidural analgesia. The composition of the analgesics in the experimental group was 0.1% bupivacaine +fentanyl 2 g/mL in 100 mL of normal saline. Pain scores were measured 3 times using a standardized pain scale containing questions regarding side effects - upon arrival at the ward, 6 hours thereafter and 24 hours after the first measurement. RESULTS: Pain scores were significantly lower in the epidural group with minimal side effects requiring no further treatment (p<0.01). A significant correlation was found between the number of boluses and the incidence of nausea/vomiting in epidural group (p<0.01). CONCLUSION: This study demonstrates the safety and efficacy of patient controlled epidural analgesia using low concentrations of bupi-vacaine and fentanyl, in pediatric patients undergoing lower extremity surgery.

A Case of Achondroplasia(Thanatophoric dwarfism)

We experienced a case of thanatophoric dwarfism with a relatively large head and shortened limbs. The diagnosis was confirmed by clinical features, radiologic examinations and autopsy. A review of literature was made briefly.