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A study on oral discomfort in gynecological cancer patients undergoing chemotherapy (화학요법을 받는 부인암환자의 구강불편감에 관한 연구)

  • 정재원
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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Psychosocial Risk Factors of Postpartum Depression (산후우울증의 심리사회적 위험요인)

  • Park, Si-Sung;Han, Kwi-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.124-133
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    • 1999
  • Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.

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The Gap between Social Stratification in the Aftermath of the 1997 Financial Crisis: The Change of Living Conditions and Daily Life as a Consumer. (외환위기 이후 계층의 양극화: 변화된 일상과 소비생활)

  • Nam, Eun-Young
    • Survey Research
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    • v.10 no.1
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    • pp.1-32
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    • 2009
  • This study examines the changes of income, everyday life and living condition of consumer in the aftermath of financial crisis. In this period financial crisis was the crucial factor behind various social problems such as the dissolution of families and individuals. This research explores the range and degree of impact on individuals and social groups after the financial crisis. We explore the social mobility in terns of maintaining middle class and falling into the lower class measured by middle class identification. The 60% of the middle class before the financial crisis maintained the middle class position and the rest of people left out of middle class and fell into lower class. The 60% of those who has been maintained and has just became the members of middle class were college - educated people. The great part of people whose income and assets has increased after financial crisis belongs to college - educated group. Many of those whose income have decreased belong to the high school educated group and blow, the older than 50 years old, self - employed without employee and unpaid family employee. Those whose income and assets decreased and those who experienced downward mobility have undergone changes in everyday life and living conditions as a consumer. Many of them experienced the unemployment, nonpayment or credit - delinquency, dissolution of family, worsening health condition, depression, feeling the impulse to commit suicide simultaneously. The poor consumer disposition, reduction of living expenses, sound consumer culture have expanded to people since economic crisis. The middle class reported that the cost of private education often goes beyond the family ability to pay. The lower class has suffered from the cost of living. In a meanwhile luxury goods preference, consumer consciousness for status symbol have continuously increased among all the classes since 1997. Thus fluctuations of one's income and social mobility during past 10 years were some of the major determinants which brought about the various damaging life events, changes of living conditions and everyday lives as a consumer.

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Review Study on Integrated Carbon Cycle System for the Dairy Cattle Production (젖소 사육에서 탄소 순환 체계에 관한 고찰 연구)

  • Kim, Ki-Youn;Ko, Han-Jong;Kim, Chi-Ho;Choi, Eun-Gyu;Kim, Joung-Ku;Ryou, Young-Sun;Kim, Hyeon-Tae
    • Journal of Animal Environmental Science
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    • v.18 no.1
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    • pp.19-24
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    • 2012
  • The first objective of this study is to estimate emission coefficient of organic carbon regarding its inflow and discharge for dairy farm through reviewing domestic and foreign literature published or reported previously. Its second objective is to provide fundamental data to establish carbon cycle system related to livestock production. Based on literature review, emission coefficients by inflow of organic carbon into dairy farm were 5.9 ton C/head/year for feedstuff ingestion by milk cow, 2.3 ton C/head/year for recycling manure compost of milk cow to grassland, 318 g C/$m^2$/year for contents in grassland, 145 g C/$m^2$/year for contents in fodder crop, and 17 g C/$m^2$/year for $CO_2$ uptake by fodder crop, respectively. on the other hand, emission coefficients by discharge of organic carbon from dairy farm were 2,9 ton C/head/year for emission of $CO_2$ and $CH_4$ by respiration and burp of milk cow, 0.4 ton C/head/year for emission of $CO_2$ and $CH_4$ by decomposition of organic carbon in manure of milk cow, 440 g C/$m^2$/year for emission of $CO_2$ from grassland, and 0 for elution of organic carbon in grassland into underground water, respectively.

Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient (어린이 영양지수 (nutrition quotient)를 이용한 제주 지역 일부 초등학생의 식습관 및 영양 상태 평가)

  • Boo, Mi Na;Cho, Su Kyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.48 no.4
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    • pp.335-343
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    • 2015
  • Purpose: The aim of this study was to evaluate the food behavior and nutritional status of elementary school students in the Jeju area using Nutrition Quotient (NQ). Methods: The subjects were 440 students (235 boys and 205 girls) in the fifth and sixth grade at four elementary schools located in Jeju. Demographic, lifestyle, and environmental information was collected using a self-reported questionnaire. The food behavior checklist for children's Nutrition Quotient (NQ), consisting of 19 items, and nutrition education related information were also obtained. Results: The mean score of the children's NQ was poor, reaching 60.3 points. The percentage distribution of NQ grade was 19.8% (lowest), 18.6% (low), 45.0% (medium), 10.7% (high), and 5.9% (highest) and the factor scores for balance, diversity, abstinence, regularity, and practice were 56.6, 68.4, 71.3, 57.4, and 54.8 points, respectively. Compared with the NQ cut-off points for defining malnutrition (balance; 57, diversity; 87, abstinence; 66, regularity; 69, and practice; 67 point), average score of abstinence factor was only above the cut-off point and scores of the other factors were below the cut-off point. Subjects with higher NQ scores tended to have higher levels of exercise activity (p < 0.001), frequency of family meals (p < 0.01), and father's educational levels (p < 0.01) compared to those with lower NQ score. NQ score showed positive association with nutrition education experience and practice (p < 0.001). Conclusion: NQ score of elementary school students residing in Jeju was lower than the national average. More opportunities should be provided for participation in nutrition education, which incorporates a range of program strategies, as well as communication and education activities.

The Eating-Related Characteristics Questionnaire and Its Correlations with Anthropometry, Nutrient Intakes, Depression, and Personality Dimensions : the Validity of Its Use on Korean College Students (대학생을 대상으로 한 섭식특성 질문지의 타당성 연구 - 체격, 영양소 섭취, 우울 및 성격차원과의 상관성에 의한 -)

  • 신동순;조옥귀
    • Journal of Nutrition and Health
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    • v.35 no.4
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    • pp.489-497
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    • 2002
  • This study was conducted to determine if Mehrabian's eating-related characteristics questionnaire could be effectively applied in predicting obesity and eating disorders among Korean college students by examining the correlations between eating-related characteristics and anthropometry, nutrient intakes, psychological aspects of depression, and personality dimensions. The data were collected from 151 female students in classes of nutrition or psychology in Kyungnam University. Measurements of height, weight and triceps skinfold thickness (TSf) were made by well-trained interviewers, and BMI was calculated. Daily nutrient intakes were obtained from the self-reported three-day dietary records for the kinds and the amounts of foods consumed by the student subjects. The students were also asked to complete three questionnaires : Mehrabian's eating-related characteristics questionnaire, Eysenck Personality Questionnaire, and the Berk Depression Inventory. The results of the study were as follows : 1) Reliability of factored homogeneous item dimensions (FHIDS) of the translated version of the eating-related characteristics questionnaire showed a similar profile compared with the original. Moreover, the loading values of Cronbach-$\alpha$ for some FHIDs, which were excluded in order to constitute primary-level factors (for example, 'predisposition to obesity' etc) with a high reliability, were much lower than Mehrabian's. Therefore the eating-related characteristics questionnaire could be effectively used for Korean students for predicting predisposition to obesity and eating disorders. 2) With regard to the relationship between anthropometric indices and eating-related characteristics, BMI measurements showed a high and a positive correlation with 'predisposition to obesity' and 'uncontrollable urges to eat', and a negative correlation with a 'predisposition to anorexia'. The heavier body weight and the more fat mass that the subjects had, the higher the probability that the subjects were overeating. 3) The intakes of some minerals (Fe, K, Na) and Vitamin C showed significantly negative correlations with a 'predisposition to obesity' and a 'predisposition to anorexia'. But the intakes of vitamin B$_2$, niacin, and retinol were positively correlated with'uncontrollable urges to eat'. 4) Among personality dimensions, neuroticism had a positive correlation with a 'predisposition to obesity', 'uncontrollable urges to eat', and 'predisposition to anorexia'. 5) Neuroticism was negatively correlated with intakes of calories, carbohydrates, K, Fe, Vitamin C, etc. On the contrary, all personality dimensions were positively correlated with intakes of retinol. In conclusion, the translated version of Mehrabian's eating-related characteristics questionnaire appears to be effective for nutritional or psychological assessments of any predisposition to eating disorders among Korean college students.

Current status of meal and snack service in elementary care classes in Gyeonggi area (경기도 지역 초등돌봄교실의 급·간식 운영 현황)

  • Yang, Hee Soon;Park, Haeryun;Song, Kyunghee;Ahn, Yoonjin;Choi, Daeun;Jin, Juntai;Lee, Youngmi
    • Journal of Nutrition and Health
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    • v.51 no.3
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    • pp.264-274
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    • 2018
  • Purpose: This study aimed to investigate the current status of food service management in elementary care classes. Methods: A focus group interview with seven care class managers and a survey with 101 care class managers using a self-administered questionnaire in Gyeonggi province were conducted. Results: In the focus group interview, purchased meals and snacks were evaluated as low quality by the care class managers. Frequent use of frozen or processed food and products with low prices were also reported as problems. Care class managers were in charge of meal and snack planning without any guidelines or expert advices. The results of the survey show that most schools serve purchased snacks and meals. The average unit costs of one meal and snack were 4,062 and 1,463 Won, respectively. The average unit costs of snacks during semester (p = 0.015) and vacation (p = 0.039) were significantly lower in rural than urban areas. The percentages of schools that prepared nutrition standards for meal and snack planning in elementary care classes were only 7.4% and 10.9%, respectively. The meal menus were mostly provided by catering service companies, and the snack menus were planned mostly by the care class managers. Menu planning by the care class managers was more usual in rural than urban areas (p = 0.054 for meal planning and p = 0.008 for snack planning). Just 33.7% of schools introduced safety standards for food service in elementary care classes, and more than half of the respondents (56.4%) did not do a regular medical check-up. Only 33.7% of the respondents received education for food safety. Conclusion: These results show the necessity for establishment of detailed guidelines for food service in elementary care classes and for the introduction of a food safety and nutrition education program customized for care class managers.

A study on Establishment and Management of the CCTV in Operating Room (수술실 CCTV 설치 및 운영에 대한 고찰)

  • Kim, Minji
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.109-132
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    • 2019
  • Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.

Internet Addiction in Adolescents and its Relation to Sleep and Depression (청소년의 인터넷 중독 : 수면, 우울과의 관련성)

  • Song, Ho-Kwang;Jeong, Mi-Hyang;Sung, Da-Jung;Jung, Jung-Kyung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Jin-Seong
    • Sleep Medicine and Psychophysiology
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    • v.17 no.2
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    • pp.100-108
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    • 2010
  • Objectives: "Internet-addiction" came into common use not only in clinical setting but also in everyday life. But, pathophysiology and diagnostic criteria of the internet addiction remain unknown. Because adolescents are in developing period, they might be vulnerable to the internet addiction, depression and sleep-related problem. The objectives of this study were to investigate the characteristics of internet addiction and its association with sleep pattern and depression in Korean adolescence. Methods: Subjects were 799 middle and high school students in Seoul, Korea. We administered a self-reported questionnaire including socio-demographic data, Korean versions of Young's Internet Addiction Scale (YIAS), Pittsburgh Sleep Quality Index (PS-QI), the Center for Epidemiologic Studies for Depression Scale (CES-D) and questions about internet using patterns. Data of 696 subjects were included in analysis. Chi-square tests were used to analyze proportional differences, and ANOVA with post-hoc tests were used to analyze differences among groups. Partial correlation analyses were performed to analyze the correlation of internet addiction with other variables (two-tailed, p<0.05). Results: Of the 696 participants (grade 2 of middle school; M2 135 vs. grade 1 of high school; H1 238 vs. grade 2 of high school; H2 323), 2.0% (n=14) were internet-addicted (IA), 27.7% (n=193) were over-using (OU) and 70.3% (n=489) were not-addicted (NA). The mean scores of YIAS, PSQI and CES-D scores were 35.24${\pm}$12.78, 5.53${\pm}$3.04 and 16.72${\pm}$8.69, respectively. In higher grade students, average total sleep time was shorter (M2 426.20${\pm}$67.68 min. vs. H1 380.47${\pm}$62.57 min. vs. H2 354.67${\pm}$73.37 min., F=51.909, p<0.001), and PSQI (4.69${\pm}$3.14 vs. 5.42${\pm}$3.15 vs. 5.97${\pm}$2.83, F=8.871, p<0.001) CES-D (13.53${\pm}$8.37 vs. 16.96${\pm}$8.24 vs. 17.87${\pm}$8.84, F=12.373, p<0.001) scores were higher than those of lower grade students. Comparing variables among IA, OU and NA groups, computer using time not for study (96.36${\pm}$63.31 min. vs. 134.92${\pm}$86.79 min. vs. 213.57${\pm}$136.87 min., F=34.287, p<0.001) and portable device using time not for study (84.22${\pm}$79.11 min. vs. 96.97${\pm}$91.89 min. vs. 152.31${\pm}$93.64 min., F= 5.400, p=0.005) were different among groups. PSQI (5.26${\pm}$2.97 vs. 6.08${\pm}$2.97 vs. 7.50${\pm}$4.41, F=8.218, p<0.001) and CES-D scores (15.40${\pm}$8.08 vs. 19.05${\pm}$8.42 vs. 30.43${\pm}$13.69, F=32.692, p<0.001) were also different among groups. YIAS score were correlated with computer using time not for study (r=0.356, p<0.001) and portable device using time not for study (r= 0.136, p<0.001). PSQI score (r=0.237, p<0.001) and CES-D score (r=0.332, p<0.001). YIAS score and PSQI score (r=0.131, p= 0.001), YIAS and CES-D score (r=0.265, p<0.001), PSQI score and CES-D score (r=0.357, p<0.001) were correlated each other. Conclusion: These results suggested that adolescents' internet-addiction was correlated with not only computer and portable device using time not for study but also depression and sleep-related problems. We should pay attention to depression and sleep-related problems, when evaluating internet-addiction in adolescents.

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Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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