Sung Reul Kim

Gait freezing and speech disturbance in Parkinson’s disease

AbstractGait freezing and speech disturbance are disabling axial features of Parkinson’s disease (PD). However, the pathogenesis of these features remains unclear. We investigated the relation between changes in gait freezing and speech disturbance using visual and auditory cues in PD. 18 PD patients, comprising of 9 patients with freezing (PDGF) and 9 without gait freezing were studied. Patients performed a 7-m back-and-forth walk in a baseline state and with visual and auditory cues. Gait velocity, stride length and cadence were evaluated using a three-dimensional gait analysis system. For speech evaluation, patients read ten sentences in a baseline state and with visual and auditory cues. The time delay of speech initiation, speech rate and the number of repetitions per sentence were quantified. In PDGF patients, the increase in gait velocity positively correlated with the decrease in the time delay of the speech initiation. Also, the increase in the gait velocity and cadence positively correlated with the decrease in the number of repetitions per sentence. The increase in the stride length positively correlated with the increase in speech rate. Lastly, the increase in stride length positively correlated with the decrease in the number of repetitions per sentence. These findings suggest that there is a common pathomechanism of gait freezing and speech disturbance in PD.

Influencing effect of non-motor symptom clusters on quality of life in Parkinson's disease

The heterogeneity of non-motor symptoms (NMSs) in patients with Parkinsons disease (PD) has been well established. We investigated the effects of NMS as a cluster on the quality of life (QoL) of patients with PD. We recruited 180 patients with PD and used a descriptive cross-sectional study design. To determine interrelationships between non-motor symptoms, a principal component analysis with varimax rotation was performed based on the Non-Motor Symptoms Scale (NMSS). Among 180 PD patients, 172 patients (96.6%) had experienced at least 2 domains of concurrent non-motor symptoms. There were two types of non-motor symptom clusters (NMSCs). The first non-motor symptom cluster (NMSC1) consisted of mood, sleep/fatigue, attention/memory, urinary symptoms, and miscellaneous symptoms, while the second non-motor symptom cluster (NMSC2) consisted of perceptual problems, gastrointestinal issues, and cardiovascular symptoms. The elderly PD patients were more often categorized as experiencing NMSC2 than NMSC1. Our subgroup cluster analysis showed that PD patients with higher scoring NMS had significantly poorer QoL in both NMSC1 and NMSC2 subgroups, with subgroup-specific patterns. NMSCs also emerged differently depending on sex and the severity of PD. In conclusion, PD patients with NMS may have a specific cluster pattern of NMSC. Some NMSCs may have a negative impact on QoL. Understanding the clinical implications of NMSC in PD patients may provide better therapeutic interventions.

Smoking Cessation Failure Among Korean Adolescents

The aim of this study was to identify smoking cessation failure subgroups among Korean adolescents. Participants were 379 smoking adolescents who joined a smoking cessation program. A questionnaire and a cotinine urine test were administered before the program began. Three months after the program ended, the cotinine urine test was repeated. A decision-tree model identified seven subgroups with low or high smoking cessation rates. The predictors of smoking cessation were intention to stop smoking, initiation of smoking, amount of cigarette use, self-efficacy, and paternal smoking status. The subgroup with the lowest smoking cessation rate included adolescents who did not have any intention to stop smoking and who had started smoking after eighth grade, and none of the participants in this group stopped smoking. The results of this study provide crucial information for tailored smoking cessation programs.

Factors contributing to malnutrition in patients with Parkinson's disease.

Our objective in this study was to evaluate the nutritional status and to identify clinical, psychosocial, and nutritional factors contributing to malnutrition in Korean patients with Parkinsons disease. We used a descriptive, cross-sectional study design. Of 102 enrolled patients, 26 (25.5%) were malnourished and 27 (26.5%) were at risk of malnutrition based on Mini-Nutritional Assessment scores. Malnutrition was related to activity of daily living score, Hoehn and Yahr stage, duration of levodopa therapy, Beck Depression Inventory and Spielbergers Anxiety Inventory scores, body weight, body weight at onset of Parkinsons disease, and body mass index. On multiple logistic regression analysis, anxiety score, duration of levodopa therapy, body weight at onset of Parkinsons disease, and loss of body weight were significant factors predicting malnutrition in Parkinsons disease patients. Therefore, nutritional assessment, including psychological evaluation, is required for Parkinsons disease patients to facilitate interdisciplinary nutritional intervention for malnourished patients.

A prediction model of falls for patients with neurological disorder in acute care hospital

For the prevention of falls, individual fall risk assessment is the necessary first step. Thus, we attempted to identify independent risk factors for falls and develop a prediction model using a scoring system for patients with neurological disorders in acute hospital settings. This study was a secondary analysis of a previous study performed to compare the reliability and validity of three well-known fall assessment tools in patients with neurological disorders. We considered comorbid diseases and potential medications in addition to variables included in the three tools. Multiple logistic regression analysis was used to develop a prediction model for falls. Predictive scores were calculated using the proportional odds ratio (OR) of each predictor. The discriminative power of this model was evaluated by receiver-operating characteristic (ROC) area under the curve (AUC) analysis. A total of 32 falls were noted among 1018 patients. History of falls (OR, 4.01; 95% CI, 1.61-9.98; p=.003), cerebrovascular disease (CVD) (OR, 2.61; 95% CI, 1.11-6.14; p=.028), severe impaired gait (OR, 7.28; 95% CI, 2.45-21.65; p<.001), and overestimate of ones own gait ability (OR, 9.14; 95% CI, 3.89-21.45; p<.001) were identified as meaningful predictors for falling after adjusting for age, diabetes, confusion or disorientation, up-and-go test, altered elimination, and antipsychotics by univariate analysis. The discriminative power of fall risk score calculated by the prediction model was 0.904 of AUC (p<.001). Our results suggest that in addition to fall history and the presence of CVD, neurological assessment for gait and insight into gait ability are imperative to predict falls in patients with neurological disorders.

Does type D personality affect symptom control and quality of life in asthma patients

AIMS AND OBJECTIVES This study aims to identify the effects of type D personality on symptom control and quality of life and to explore factors influencing quality of life among asthma patients in Korea. BACKGROUND Psychological factors such as depression and stress are well known to be related to medical outcomes and quality of life in asthma patients. People with type D personality are vulnerable to stress, show poor prognosis in disease and experience low quality of life. DESIGN A descriptive cross-sectional design was used. METHODS A total of 144 patients with asthma participated in this study. Data were collected through face-to-face interviews using structured questionnaires: the Type D Personality Scale-14, Asthma Control Test and Asthma-Specific Quality of Life. RESULTS About 33% of participants were classified into the type D personality group. The type D personality group showed statistically significantly lower symptom control and asthma-specific quality of life compared to the non-type D personality group. Based on forward stepwise multiple regression, the most significant factor of quality of life was symptom control, followed by type D personality, hospitalisation within the previous one year, and lifetime hospitalisation experiences. CONCLUSIONS The prevalence of type D personality in asthma patients was high, and type D personality was significantly associated with poor symptom control and low quality of life. Psychosocial interventions might be beneficial to improve symptom control and quality of life in asthma patients with type D personality. RELEVANCE TO CLINICAL PRACTICE Nurses should be aware of the high prevalence of type D personality and the effects on symptom control and quality of life in asthma patients. Nurses should also provide personality-specific interventions to improve quality of life in such patients.

Influence of type D personality on job stress and job satisfaction in clinical nurses: the mediating effects of compassion fatigue, burnout, and compassion satisfaction

AIMS To test a hypothetical path model evaluating the influence of type D personality on job stress and job satisfaction and to identify the mediating effects of compassion fatigue, burnout, and compassion satisfaction among clinical nurses in South Korea. BACKGROUND Personalities susceptible to stress, compassion fatigue, and burnout in clinical nurses have negative effects on the job stress and job satisfaction. DESIGN A correlational, cross-sectional design was used. METHODS A convenience sample of 875 clinical nurses was recruited between December 2014 - February 2015. The structured questionnaires included the Type D personality scale-14, Professional Quality of Life, job stress, job satisfaction, and general characteristics. To test the hypothetical path model, we performed a path analysis by using the AMOS 18·0 program. FINDINGS Based on the path model, type D personality was significantly associated with compassion fatigue, burnout, and compassion satisfaction in our study subjects. Type D personality was significantly associated with job stress and job satisfaction via the effect of burnout, compassion satisfaction, and job stress. CONCLUSION Since type D personality is associated with job stress and job satisfaction, identifying personalities vulnerable to stress would help to address job stress and to enhance job satisfaction when nurses have a high level of compassion fatigue and burnout and a low level of compassion satisfaction. The development of interventions that can reduce negative affect and social inhibition of nurses with type D personality and investigation of methods to decrease their compassion fatigue and burnout and to increase compassion satisfaction should be encouraged.

Association among type D personality, non-motor symptoms, and quality of life in Parkinson's disease: A cross-sectional study

ABSTRACT Patients with type D personality are vulnerable to stress, show poor prognosis in disease, and experience low quality of life. The aims of this study were to identify the associations among type D personality, non‐motor symptoms, and quality of life in patients with Parkinsons disease (PD). Data were collected between May 28 and August 6, 2015 from a convenience sample of 196 PD patients. About 20% of participants were classified into the type D personality group. This group experienced statistically significantly higher non‐motor symptoms and lower quality of life compared to the non‐type D personality group. Based on stepwise multiple regression analysis, the most significant factor affecting quality of life was non‐motor symptoms, followed by type D personality, disease severity, and duration of disease. Understanding the clinical implications of type D personality might be beneficial in the management of non‐motor symptoms and quality of life in PD patients. HIGHLIGHTSThe patients with type D personality experience high non‐motor symptom in PD.Type D personality is associated with poor quality of life in PD patients.Type D personality is an independent factor influencing quality of life in PD.Physical and psychosocial interventions might be beneficial in PD patients.

Waiting for a kidney transplant: the experience of patients with end-stage renal disease in South Korea

AIMS AND OBJECTIVES To explore the experiences of Korean patients with end-stage renal disease awaiting kidney transplantation. BACKGROUND The need for kidney transplantation has increased worldwide, while the number of kidney donors has not increased commensurately. This mismatch is a serious issue in South Korea. Prolonged waits for transplantation may cause physical and psychosocial issues and lead to poor outcomes. Nevertheless, the experience of waiting for kidney transplantation in South Korea has never been explored in depth. DESIGN A qualitative descriptive design was used. METHODS The participants were eight patients diagnosed with end-stage renal disease on the waiting list for kidney transplantation in South Korea. Data were collected through individual in-depth interviews. All conversations during interviews were recorded and transcribed verbatim. Transcribed data were analysed using conventional content analysis. RESULTS The experience of waiting for kidney transplantation consisted of six categories: (1) the light at the end of the tunnel, (2) being on call without any promise, (3) a tough tug of war between excitement and frustration, (4) doubts in the complexity, (5) A companion on the hard journey and (6) getting ready for D-day. CONCLUSIONS Kidney transplantation candidates experience psychosocial difficulties and concerns while waiting for long periods of time without any assurance of resolution. Systematic education and psychosocial support from health care professionals and family members help patients get through what they describe as a difficult journey. Comprehensive management programs for kidney transplantation candidates are needed. RELEVANCE TO CLINICAL PRACTICE Health care professionals need to recognise the psychosocial concerns of patients awaiting kidney transplantation. Clinicians should provide patients with information and support throughout the waiting period.

Reliability and Validity of the Korean Version of the Dimensions of Tobacco Dependence Scale for Adolescents

This study assessed the reliability and validity of the Korean version of the Dimensions of Tobacco Dependence Scale (DTDS) for adolescents in Korea. The DTDS, Modified Fagerström Tolerance Questionnaire (M-FTQ), and urine nicotine test were administered to 360 Korean adolescents. The collected data were analyzed using SPSS 21.0 and AMOS 21.0. The construct validity, criterion validity, test-retest reliability, internal consistency reliability, and the area under the curve (AUC) of the Korean version of the DTDS were evaluated. The 4-subscale model of the DTDS (with social, emotional, physical, and sensory subscales) was validated using confirmatory factor analysis, and criterion validity was demonstrated with the M-FTQ. Furthermore, the AUC of the DTDS was 83.1. The Cronbach’s α coefficient for internal consistency was .96, demonstrating sufficient test-retest reliability. The Korean version of the DTDS is a reliable and valid measure of tobacco dependence among Korean adolescents.