| Dong Wook Lee | 8 Articles |
Background
Gastroscopy is the useful method to detect the upper gastrointestinal condition, but examinee have recognized it as the procedure causing the discomfort and anxiety. This study was conducted to identify the factors related to pre-procedural anxiety for gastroscopy .Methods: From 9th March to 12th June 2009, Data were collected from 463 examinee undergone gastroscopy at a health promotion center of a university hospital by self-administered questionnaires about general characteristics (age, sex, education state, economic state, family history of gastric cancer), gastrointestinal symptom, histroy of gastrointestinal disease, sedated gastroscopy and previous experience of gastroscopy. Before gastroscopy procedure, pre-procedural anxiety was assessed using 20-items by Korean version of Spielberger State Triat Anxiety Inventory Form-Y (STAI-Y).Results: The mean score of pre-procedural state anxiety was 38.1 ± 10.2 in all participants. The mean score was the most highest in participants who had no previous experience of gastroscopy and would perform non-sedated gastroscopy as 42.1 ± 10.3. Factors related to pre-procedural anxiety were female (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.94 to 4.64), low education state (OR, 1.68; 95% CI, 1.05 to 2.71) and the previous experience of gastroscopy (OR, 0.46; 95% CI, 0.24 to 0.88). Among participants who had the previous experienced gastroscopy, female (OR, 3.20; 95% CI, 1.97 to 5.22), low education state (OR, 1.79; 95% CI, 1.06 to 3.02) and the good tolerance at previous gastroscopy (OR, 0.35; 95% CI 0.21 to 0.59) were related to pre-procedural anxiety. Conclusion: In health check examinee, female, low education state and the no previous experience of gastroscopy were related to pre-procedural anxiety. Endoscopists should be provide efforts to lower pre-procedural anxiety in those subjects as to increase effectiveness of interventions. Citations Citations to this article as recorded by
Background
Understanding lung sound is important physical examination of chest. We studied to identify the state of the understanding, the education and the self-learning experience for lung sound's interpretation during the residentship training period. Methods: Data were collected from 45 family medicine residents who had trained in Daegu and Gyeongbuk from April 1st to May 31th 2008. Residents completed self-administered questionnaire about the education and the self-learning experience for lung sound's interpretation and had been estimated the understanding of lung sound by using the audio file of five lung sounds. Results: The median score (inter-quartile range, IQR) of lung sound's interpretation was 2 (1, 3) between 0 and 5 range. The number of residents who were educated for the interpretation of lung sounds during the training period were 10 (22.2%). Twenty-four (53.3%) had the self-learning experience for lung sounds. Conclusion: The understanding for lung sounds of family medicine residents in Daegu, Gyeungbuk was not high and the majority of residents were not educated the interpretation of lung sounds during the training period. Directors of family medicine should consider to make the regular education program for interpretation of lung sound during the training period.
Background
Esophagogastroduodenoscopy is a very important method to detect gastroduodenal lesions. But the investigation might be delayed due to its own discomfort and anxiety. This study was performed to evaluate the effect of relaxation music on relief of anxiety and physical discomfort during unsedated esophagogastroduodenoscopy. Methods: From March 3 to May 14 2009, 104 clients who have undergone unsedated esophagogastroduodenoscopy more than once in the past were enrolled in this study. The subjects were randomly assigned to receive either relaxation music (music, N = 52) or no music (control, N = 52) before esophagogastroduodenoscopy. The subjects recorded their anxiety and physical discomfort about latest and today endoscopy by visual analogue scale (VAS). At pre and post music listening, systolic, diastolic blood pressure and heart rate were measured. Results: There was a significant difference of anxiety VAS between music and control group (music, decrease 1.1 ± 2.1; control, increase 0.0 ± 1.9; P = 0.008). Throat discomfort VAS was not significant (music, decrease 0.9 ± 1.8; control, decrease 0.5 ± 2.7; P = 0.33). Dyspnea VAS decreased in both groups (music, 0.6 ± 2.2; control, 0.4 ± 2.5; P = 0.68). Nausea & vomitting VAS also decreased in both group (music, 0.9 ± 2.2; control, 1.1 ± 2.1, P = 0.71). There were no significant vital sign changes premusic and postmusic, In both group vital signs increased. Mean differences of systolic pressure(1.0 ± 11.4 vs. 1.6 ± 11.1) and diastolic pressure (0.7 ± 7.3 vs. 1.3 ± 5.7) were lower in music group, and mean difference of heart rate (1.8 ± 9.5 vs. 1.5 ± 8.0) was lower in control group. But There were no significant vital sign changes premusic and postmusic (each P = 0.8, P = 0.62, P = 0.89). Conclusion: Listening relaxation music before unsedated esophagogastroduodenoscopy may reduced anxiety. Citations Citations to this article as recorded by
Background
A previous Korean study recommended minimal 50 cases of Esophgogastroduodenoscopy (EGD) to achieve technical competency, based on director's opinion. Therefore, this study was conducted to evaluate the achievement of EGD's technical skills during the first 50 EGD cases. Methods: The data were collected from the first 50 EGDs consecutively performed by six family medicine residents trained the EGD procedure in one residency program from 2004 to 2006. Technical competency of the EGD procedure was evaluated in 4 steps divided with anatomical landmarks (the gastroesophageal junction, the antrum, the fundus of the stomach, and the second portion of the duodenum). Authors measured the procedure time of EGDs performed by residents in 4 steps and calculated the rate of success cases satisfied with author's own criteria made by procedure time. Results: The success rate of EGD procedure in all steps was 26.7% at 10 EGDs, but sharply increased to 80.0% at 30 EGDs, reached 88.0% at 50 EGDs. Fail to perform esophageal intubation and retroversion to the fundus of the stomach was none after 30 EGDs. However, in steps from gastroesphageal junction to the antrum of the stomach and from the antrum of the stomach to the second portion of the duodenum, the failure rate kept up less than 10% during the first 50 EGDs. A statistically significant reduction of the procedure time in success cases was observed between 20 and 30 EGDs in all steps. Conclusion: The technical competency of EGD was achieved approximately 90% during the first consecutive 50 EGDs. Citations Citations to this article as recorded by
Background
Freshmen maladaptation to university life has brought a lot of attention recently. Therefore, we intended to investigate about the relationship between anxiety, depression, stress and freshmen adaptation to university life. Methods: We recruited 861 freshmen of a university located in Gyeongju, Gyeongbuk, and measured their degree of anxiety, depression, and stress by questionnaire from March 10 to 14, 2008. After 8 weeks, we examined their adaptation to university life by questionnaire and fi nally, analyzed the data of 600 freshmen. Results: Among the freshmen, 285 (47.5%) had anxiety, 95 (15.8%) depression, and 70 (11.7%) stress. Adaptation to university life significantly associated with college-entrance exam experience, the number of close friends in class, willingness to join the club, major satisfaction and distance from the university to hometown, in addition to anxiety, depression, and stress. Risk factors of maladaptation to university life were stress (odds ratio: 2.66, 95% confidence interval: 1.60 to 4.45), depression (2.45; 1.56 to 3.84), one experience of college entrance exam (1.83; 1.24 to 2.69), anxiety (1.73; 1.27 to 2.37) and fewer than 5 close friends (1.60; 1.17 to 2.20). Short distance from the university to hometown (0.72; 0.53 to 0.98), willingness to join the club (0.60; 0.41 to 0.87) and major satisfaction (0.42; 0.29 to 0.61) were identifi ed as lowering the risk of maladaptation to university life. Conclusion: Anxiety, depression, and stress closely related to freshmen adaptation to university life. During freshmen's health examination, we need to identify the degree of anxiety, depression and stress in order to predict maladaptation to university life. Citations Citations to this article as recorded by
Background
Angiotensin converting enzyme inhibitors (ACEIs) or Angiotensin II type 1 receptor blockers (ARBs) are compelling indication drugs for hypertensive patients with diabetes mellitus. But prescription rate in 2005 year study of Pohang · Gyeongju area was only 30.8%. Therefore, a study on the change of prescription rate in the same area after 3 years was done.Methods: During three months from January 2008, 152 hypertensive patients with diabetes mellitus on their prescribed antihypertensive medications by 9 family physicians in visiting order were analyzed. After the analysis, the infl uencing factors for such prescriptions were ascertained by directly visiting each physicians who prescribed them. Results: A regimen of 16 antihypertensive agents were prescribed by these family physicians. Prescription count of ACEIs or ARBs was 101 cases (66.4%). ACEIs single therapy was 19 cases (12.5%), ACEIs combination therapy was 7 cases (4.6%), ARBs single therapy was 31 cases (20.4%) and ARBs combination therapy was 44 cases (28.9%). The ACEIs or ARBs which were selected by physicians that followed "compelling indication" was 5 (55.6%), "excellent reduce pressure effect" was 3 (33.3%) and "public relations of new medicine" was 1 (11.1%).Conclusion: In prescribing antihypertensive agents for patients with diabetes mellitus, selection of ACEIs or ARBs was increased from 30.8% to 66.4%. Education of recommended standard by participating in such study and developing of excellent new medicines may increase such change. Citations Citations to this article as recorded by
Residents in family medicine often have difficulty of gathering to have a conference when they are sent to different hospitals according to training programs. From 2001, for resident conference of family medicine in pohang hospital and gyeongju hospital, dongguk university medical center, an Internet-based video conference system was used for video conferences. The Internet-based video conferences for the members who work at difference hospitals had the same effects as they gather at one place. In addition, the participants could lower the burden of preparing the presentation, listen to the presentation lively, and have a discussion with questions and answers immediately, enhancing the efficiency of conferences. They also could have a sense of affinity as they talk face to face. We reported this case as the application cases and effects of Internet-based video conferences. (J Korean Acad Fam Med 2007;28:375-378)
Background
: Angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker is usually recommended for hypertensive patients with diabetes mellitus. No reports have been made on antihypertensive agents prescribed for these patients in private practice. Methods : During a one month period of December 2004, 169 hypertensive patients with diabetes mellitus on their prescribed antihypertensive agents by ten family physicians were analyzed. The influencing factors for such prescriptions were analyzed by directly visiting each physicians who prescribed them. Results : A total of 21 antihypertensive agents were prescribed by these family physicians. Single calcium channel blocker therapy was the most common with 55 cases (32.5%), followed by 20 cases (11.8%) of single angiotensin converting enzyme inhibitor therapy and 16 cases of single therapy of Angiotensin II type 1 receptor blocker. The low frequency of prescribing the Angiotensin II type 1 receptor blocker was due to insufficient effect (7), lack of information (5), resistance from the patients from changing the medications (4) and expensive costs (4). Conclusion : In prescribing antihypertensive agents for patients with diabetes mellitus, angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker were chosen less. In order to decrease the incidence of complications in these patients, such agents should be prescribed more.
|
|
