| Jung Bum Lee | 13 Articles |
Background
Aging process causes several changes in the typical sleep patterns. Elderly people complain frequently about sleep duration, changes of sleep/wake rhythm and day time sleepiness. This study was performed to evaluate improvement of sleep quality after laughter therapy. Methods: On July 2007, the study participants aged over 65 were recruited through a community center in Daegu. There were 48 subjects in the experimental group and 61 in the control group. The laughter therapy program was applied to the experimental group. We compared Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) before and after laughter therapy. Data were analyzed by independent t-test, chi-square test, paired t-test, and ANCOVA using SPSS windows ver. 14.0. Results: At initial study, there were no signifi cant differences in baseline characteristics. The ISI scores were 8.00 ± 6.29 and 8.36 ± 6.38; the PSQI scores were 6.98 ± 3.41 and 7.38 ± 3.70; The Geriatric Depression Seals (GDS) scores were 7.98 ± 3.58 and 8.08 ± 3.95 in experimental and control groups, respectively. After laughter therapy, the ISI scores were 7.58 ± 5.38 (P = 0.327) and 9.31 ± 6.35 (P = 0.019), PSQI scores were 6.04 ± 2.35 (P = 0.019) and 7.30 ± 3.74 (P = 0.847), GDS scores were 6.94 ± 3.19 (P = 0.027), 8.43 ± 3.44 (P = 0.422) in experimental and control groups, respectively. Conclusion: The laughter therapy is considered to be useful for the elderly people in a community that improves insomnia and sleep quality. Citations Citations to this article as recorded by
Background
: Reduced pulmonary function is a common outcome in pulmonary patients with reduced bone mineral density. But, there are few studies on the relationship in adult females who do not have pulmonary diseases. Thus, this study was to assess the correlation between bone mineral density and pulmonary function in healthy women. Methods : A total of 193 subjects was selected among adult females who visited a health promotion center. BMD was measured by Dual energy X-ray absorptiometry and T-score of lumbar spine (L1-L4) was used. Pulmonary function was measured by spirometer and questionnaire survey was used to obtain information from the subjects. Results : Mean T-score of L-spine was -0.284, FEV1 (pred %) was 98.82% and BMI was 23.50 kg/m2. The results showed positive correlation (0.128) between BMD and FEV1 by multiple regression analysis (P＜0.05). Conclusion : As FEV1 of subjects increased, BMD increased in adult women who did not have pulmonary diseases.
Background
: Tools such as SCORE (Simple Calculated Osteoporosis Risk Estimation) and ORAI (Osteoporosis Risk Assessment Instrument) have been used for screening test of osteoporosis, These tools include race, age, weight, BMI, previous treatment with HRT and so on, as confounding factors. Among those factors, it has been reported that body weight is more appropriate than BMI. But those study were based on Caucasian women and not based on Korean women. Therefore, comparison among Korean women needed to be assessed. Methods : A total of 200 postmenopausal women in ages 50 and over were enrolled in health promotion center of one university hospital. BMD was checked by DEXA of lumbar spine (L1-L4) from January 2002 to May, 2003. Women who had previous history of endocrine disease or medications, early onset menopause, previous surgery of uterus and ovary, which all could influence BMD, were excluded. Results : The average age was 58.01, the average weight 58.36 kg, the average BMI (kg/m2) 24.39, the average BMD (t-score) -1.00. Among the total 26 women (13%) recorded BMD (t-score)≤-2.5 and 50 women (25%) recorded -2.5＜BMD (t-score)≤-1.5. Multiple regression analysis showed body weight was superior to BMI in predicting BMD (t-score). A logistic regression analysis on the likelihood of being osteoporotic (T-score＜-2.5) further confirmed this finding. Conclusion : Patient body weight was more effective and useful than BMI in explaining BMD T-score as compared to BMI Korean postmenopausal women.
Background
: Hypertension is a common, chronic disease that poses as a main risk factor of coronary artery disease. Therefore, it requires accurate diagnosis. This study attempted to examine the problem of misclassification and accurate diagnosis of hypertension in primary care settings and to consider the relationship between variability of blood pressure and number of measurements. Methods : Among the 158 patients with initially high blood pressure who visited health screening center of one university hospital from May to November, 199,97 persons who corresponded to the following conditions were chosen for this study. We classified hypertension as stage 1 and 2. The subjects were not previously diagnosed as hypertensive and had no past history of use of antihypertensive medication. Blood pressure was measured according to 1999 WHO/ISH Hypertension Guideline, and two or more measures were performed at each visit on five separate occasions at one week intervals. Results : The mean of initial blood pressure was 159.6 mmHg in systole, 95.3 mmHg in diastole. The mean of subsequent blood pressure was 155.6 mmHg, 146.1 mmHg, 143.4 mmHg, 138.7 mmHg in systole and 92.5 mmHg, 88.4mmHg, 87 mmHg, 85.1 mmHg in diastole, which showed the tendency to be lower. In both systole and diastole, the mean differences between first and second measurements, second and third measurements were significant, but insignificant between third and forth measurements, and forth and fifth measurements. We divided systolic and diastolic pressures ito two subgroups according to stage 1, 2 classification of hypertension. In stage 1 subgroup, the means of blood pressures were lower from 151.3 mmHg to 135.4 mmHg in systole, from 95.1 mmHg to 85.3 mmHg in diastole, but there were not significant. In stage 2 subgroup, the mean blood pressure was lower from 169.7 mmHg to 142.5 mmHg in systole, form 105.4 mmHg to 87.8 mmHg in diastole, and the mean differences between first and second measurements, second and third measurements were significant, but not significant between third and forth measurements, and forth and fifth measurements. Conclusion : Blood pressure tends to be checked significantly lower until subsequent third measurements, but not thereafter. We think that more studies to find out how many blood pressure measurements are needed for diagnosing hypertension in consideration of patient's blood pressure level and risk factors.
Background
: An association between low serum cholesterol concentrations and depressive symtoms has ever been found in several studies. The objective of this study is to evaluate neurotic symptoms in hypocholesterolemia. Methods : In the course of two months (from June to August, 1998), 81 subjects were selected among the people who screened in adult disease survey of one university hospital. As the control group, 80 subjects were selected from a healthy population. In the study population, we excluded people who had medical history of hypertension diabetes mellitus, ischemic heart disease, chronic liver disease and history of any medication to lipid metabolism and other psychotic disease history. Neurotic symptoms were measured by Symptom Checklist for Minor Psychiatric Disorders (SCL-MPD) questionnaire. Results : There was no difference between the distribution of age and sex in the hypocholesterolemia groups. As the level of the education and kind of employement, no significant difference between two groups. Hypocholesterolemia groups scored significantly higher than conrol group in some questionnaire of SCL-MPD. The results of depression scale (p<0.01) and anxiety, hypochondriasis scale (p<0.05) were significant. The men of hypocholesterolemia groups have significant relation to hypochondriasis scale (p<0.001) and the women to anxiety scale (p<0.05) Conclusion : Though in some scale of neurotic symptoms, the association between hypocholesterolemia and neurotic symptoms was found in our study. There need to be a further study on the correlation of hypocholesterolemia and neurotic symptoms.
Background
: Although elevated serum cholesterol level has been considered as a significant health problem because it is associated with coronary artery disease, the relation with various health problem (esp. depression) from low serum cholesterol is not well known in Korean people. The authors tried to observe the degree of depression in low serum cholesterol group for its better management. Methods : The study population was selected among adults who visited the National University Hospital Health Screening Center between May and July 1998. They had no history of cancer and liver disease and no significant medical illnesses which may affect blood cholesterol level. Using the Korean standard BDI, we evaluated the degree of depression scale. Results : The number of subjects with low serum cholesterol was 77 (males 42, females 35) and that of the control group was 82 (males 47, females 34). The low serum cholesterol group had a statistically significantly higher BDI score(12.2±8.2) than the control group(7.6±6.3) (P<0.05). In males the mean BDI score of 11.9±7.4 in the low serum cholesterol group was significantly higher than the mean score of 5.0±3.8 in the control group(P<0.5), In females, there was no significant difference in depression scale between both groups. Conclusion : Since the male low serum cholestrerol group had a high depression scale, the multi disciplinary approaches which include psychological supports may be required to manage and treat them. And persistent, significant association between low serum total cholesterol level and psychological problems suggests that further long-term study on the association of low choleserol with depression is necessary.
Background
: Compared to Europe and America neurotic chest pain patients seems to be much more prevalent in Korea. This study was designed to depict various neurotic symptoms of patients with inorganic chest pain. Methods : In the course of one year(from March, 1997 to March, 1998), 70 subjects were selected among the people who visited the outpatient clinic of department of family medicine with symptom of chest pain. The control group was selected from a healthy population which matched nearly the same number as the chest pain group. Patients were tested by EKG, treadmill, chest X-ray, 2D-UCG and requested to answer SCL-MPD questionnaire. Statistical analysis by means of SPCC/PC + and for significance using non-parametric Mann-Whitney U teat was done. Result : The chest pain group scored significantly higher than the control group in obsessive and compulsive, anger-hostility, depression, anxiety and somatization scale. Male chest pain group scored higher in somatization, anxiety, obsessive- compulsive, hypochondriasis, and depression scale. The female chest pain group scored higher in depression scale. Conclusion : Many inorganic chest pain patients complain through various neurotic symptoms. When approaching chest pain patients we should consider the possibility of a psychosocial cause.
BACKGROUND
It is very important for family physicians to practice with comprehensive approach to patients with chronic illness. A study was done to assess psychosocial aspects of patients with chronic illness and disability and to help physicians manage patients effectively. METHODS SCL-MPD questionnaires were done in 93 patients with chronic illness and disability who were admitted between April and May in 1997. The results were statistically analyzed by chisquare test and Mann-Whitney U test. RESULTS 1. The mean score of SCL-MPD were 17.5 for `depression' and 13.78 for `somatization' with statistical significance(P<0.005). 2. Comparison of dimensions of patients with back pain syndrome had higher scoresn for `depression (25.2)', `somatization (22.1)', `hypochondriasis (14.7)', `phobic anxiety (11.6)', `neurasthenic (8.1)' and `interpersonal sensitivity(8.0)' than other disease groups with statistical significance (P<0.05). 3. In comparison of dimensions between males and females, the female group gradually had higher scores than males and, especially, 'somatization' dimension was significantly higher in score (P<0.05). 4. Symptoms ranked top in male and female patients were `54-over coscern about your health' in males and `16-over concern with the fear of having a serious illness' in females. CONCLUSION Family physicians have to consider not only physical impairment but also psychological aspect of patients with chronic illness for comprehensive management in medical practice.
Background
: The modern people ilive in excessive stress. This stress seems to be related to various diseases. The increase of daily stressful life also seems to relate closely to serum lipids and antioxidants. This study attempted to show how much daily life stress affects serum lipids and antioxidants. Methods : sixty one healthy people who visited health screening center of a university hospital were enrolled for this study from October to November, 1998. In the survey of daily life stress, the Holmes and Rahe’s Readjustment Rating Scale, which was modified by Hong and Jung were used. The subjects were interviewed about the life stress during the past one year. The levels of retinol, B-carotene, vitamin C, tocopherol, HDL-cholesterelol, LDL-cholesterol, total cholesterol, triglyceride were measured. The subjects were divided into three groups by the stress scores. Kruaskal-Wallis test was used for analysis. Dependent variables were antioxidants in each group. Results : There was no significant meaning in the comparison between each stress groups and the level of serum lipids, and between each stress group and the level of antioxidants. Conclusion : The level of antioxidants was not related to stress. More studies are needed for further evaluation of the results.
Background
: Smoking is closely related to pulmonary diseases, especially pulmonary function. Past studies were defective in that pulmonary function was not included for ex-smokers and the study population being too small. This study attempted to show the change of pulmonary function parameters according to post-smoking years of ex-smokers and pack-years of current smokers. Methods : We analyzed the results of parameters derived from the forced expiratory spirogram in 3,713 adults who visited Kyungpook National university Hospital Health Screening Center between May 1997 and March 1998. Independent variables used were age, sex, height, weight and smoking status. Dependent variables were pulmonary function parameters. Multiple regression analysis was used. Results : 1. Overall, there was a significant change in pulmonary function parameters among the subjects studied. Significant variables shown were age, sex, height and pack- years. Weight and post-smoking years turned out to be relatively less significant variables. 2.Positive correlation was seen in both FEV1/FVC and FEF25-75% in ex-smokers with longer post-smoking years. 3.There was negative correlation in all the parameters of current smokers with longer pack-years. Conclusion : The results of this test show that smoking slowly reduce pulmonary function and even those smokers who quit smoking can not be expected to have normal pulmonary function as healthy nonsmokers. However, ex-smokers can expect some improvement in certain pulmonary function parameters as the post-smoking years become longer.
Background
: Headache is one of the most common medical complaints. The majority of headaches are not associated with significant organic disease. Many persons are susceptible to headaches at times of emotional or physical distresses. The purpose of this study is to evaluate neurotic symptoms of headache patients. Methods : The present study was made in the patients whit headache symptoms. who had visited the outpatient clinic of Family Medicine of a University Hospital form April 1st to July 31st, 1996, 110 subjects with headaches and 136 controls which were closely matched according to sex, age and socioeconomic status. Neurotic symptoms were assessed using the Symptom Check List for Minor Psychiatric Disorders(SCL-MPD). The statistical analysis was made between the two groups. Results : 1) All but 3 items were significantly higher in headache group(p<0.05 : 2 items; p<0.01: 9 items; p<0.001: 53 items). 2)The headache group had a statistically significant higher score of the each neurotic dimension in comparison of the non-headache group(somatization, anxiety, depression, anger-hostility, interpersonal-sensitivity, phobic anxiety, obsessive-compulsive, neurasthenia, hypochondriasis and general)(p<0.001). 3)The age and the presence of occupation were significantly associated with headache symptoms. The somatization and depression scales had the strongest independent association with headaches as compared with other dimensions. Conclusion : Persons with headache had higher levels of neurotic symptoms and psychological distresses compared to the non-headache group. Physicians need to be aware of the various types of distresses comprehensively with psychosocial assessments and evaluations.
Background
: Fatigue is one of the most common complaints of primary care practices and consists symptoms of physical diseases and neurotic symptoms. This study was con-ducted to find that fatigue related to neurotic symtoms is an important as fatgue related to symptoms of the physical diseases itself. In addition to it, this study is to clarify and to understand the details of the neurotic symptoms. Methods : In the course of six months(from April to september, 1996). the 73 subjects were selected among the people that visited the outpatient department of family medicine with symptom of fatigue. The control group was selected from the healthy population which matched nearly the same number as the fatigue group. As tolls of measurement, we used SCL-MPD consisted of 67 items. We performed statistical analysis among the data by means of SPSS/PC+. We analysed statistical data for significance using non-para-metric Mann-Whitny U test. Results : There was no difference between the prevalence of men and women in the fa-tigue group. As the level of education decreased and employement increased, the proportion of patients that complained of fatigue increased. The fatigue group scored significantly higher than the control group in all questionnaire of SCL-MPD. The results of the somati-zation scale and phobic-anxiety were significantly high(p<0.01) and the rest of the scales were even more significantly high(p<0.001). Women scored higher in all aspects of SCL-MPD than men. Conclusion : The author emphasize the importance of neurotic symptoms related to fati-gue and biopsychosocial approach towards the patient. Considering the increase in medical cost and the decrease in productivity due to fatigue, there needs to be a thorough study of fatigue.
Background
: Chronically disabled rehabilitating patients influence their family members by their physical dysfunction. The purpose of this study was to know the relation of family function and physical function in disable person who is periodically treated in rehabilitation department. Methods : To know the family function according to physical disability, 64 patients(M/F : 40/24) in rehabilitation clinic in 1 university hospital was studied by questionnaires including ADL(activity of daily living), IADL(instrumental activity of daily living), FIM(functional independence measure), family APGAR. Results : Causes of disabilities were stroke 2, traumatic brain injury 14, fracture 16, spinal cord injury 12, burn 2, arthritis 9, back pain syndrome 9 in order. Physical function of functional families was better than dysfunctional families. And physical function according to FIM score was statistically significant(P<0.05). Physical function was significantly(P value, ADL : 0.021, IADL : 0.009, FIM : 0.005) correlated with family APGAR score. Conclusion : Physical function and family function in rehabilitating patients with irreversible disability have significant correlations. Physician have to consider family function and dynamics in care of physically disabled patients.
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