• The Journal of Korean Medicine
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• v.45 no.1
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• pp.182-201
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• 2024

Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

• Quality Improvement in Health Care
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• v.3 no.2
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• pp.52-59
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• 1997

Background : In many Nursing Delivery System, Nursing Department at D Hospital had used to traditional nursing practice model what is called functional activities based system. It has a lot of merit that carried out specialized and rapid works but tend to ignore indivisual professional responsibility and task-based work assignments. In addition this system showed high turnover rates due to heavy workload, timesum of handing over duties, lack of support from peers and interstaff communication. So we performed conversion of Nursing Delivery System to My Patients Nursing Care System for providing comprehensive nursing to patient and reducing turnover rates and increasing job satisfaction to nurse. Method : 1. 1st step(96.4.9): Detected the problem of Nursing delivery System and estabilished improving planning 2. 2nd step(96.4.26): Visited other hospital on job training 3. 3th step(96.4.29): Discussed to premonitoring problem after conversion Nursing Delivery System and prepared structure 4. 4th step(96.5.6): My Patients Nursing Care System practical application 5. 5th step(96.7.20): Held complementary meeting 6. 6th step(96. 7): The other ward application 7. 7th step(96. 10): Extended application to whole wards Results: 1. Workload: (1) reduction(55.6%) (2) addition(44.4%) 2. Strong points after conversion: (1) decreased timesum of handing overduties (35.2%) (2) increased responsibility(33%) (3) broaden nurse's outlook to duties(14.8%) 3. Shortcoming after conversion: (1) understanding difficulties except my patient(57.8%) (2) weak teamwork(23.3%) (3) intensive stress to low grade nurse(12.2%) 4. Effective complemental way: (1) manpower(76.7%) (2) conversion of though (8.9%) (3) education(14.4%) 5. Patient's satisfaction: (1) satisfaction(64%) (2) no effect(36%) 6. Physician and peer's satisfaction: (1) satisfaction(12.5%) (2) dissatisfaction(21.6%) (3) no interest(44.3%) 7. Nurse's satisfaction: (1) satisfaction(74.7%) (2) dissatisfaction(5.5%) (3) unknown(20.5%) 8. Want to continued: (1) want(76.4%) (2) try to any other system(18%) Conclusion : Even though Nursing Delivery System conversion still has many problem, we gained more merits than traditional nursing delivery system. So we suggest that My Patients Nursing Care System should be encouraged for comprehensive nursing care and satisfaction to nurses.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.4
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• pp.446-452
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• 2014

Objective: This study aimed to evaluate the exposure status of formaldehyde(FA) among the nurses in ambulatory care departments of university hospital. Methods: Two university hospitals were surveyed. The FA concentration in air were measured to target 62 nurses in 8 ambulatory care departments(89 samples). Air sampling and analysis of FA were carried out according to the OSHA Method ID-205. The survey was conducted with questionnaire asking about how to control FA and whether the nurses use the formaldehyde protectors or not. Results: FA was detected in all samples. The maximum concentration of FA was 0.258 ppm and the geometric mean was 0.023 ppm. There was no sample that exceeded any of exposure standards by OSHA-TWA whereas there were 54 samples(60.7%) that exceeded the standards by NOISH-TWA. Among 62 nurses handling FA, 13 nurses(21.0%) used the protective gloves while nobody used a gas mask. It was assessed that any of 8 common ambulatory care departments did not use a safety cabinet for FA in which local exhaust ventilation was fixed. Conclusions: Nurses in ambulatory care departments were exposed to FA. Therefore, the environment management of a workplace, the health management of a nurses, FA handling education and installing a FA cabinet with a local exhaust ventilation were needed because FA as a carcinogen was able to cause any cancer to a human body if it was emitted in air for long time.

• Health Policy and Management
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• v.25 no.1
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• pp.40-52
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• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• Journal of the Korean Society of School Health
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• v.14 no.1
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• pp.145-160
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• 2001

The main purpose of this study is to identify the effects of a structured nursing intervention program on dysmenorrhea in middle school girls. This study employed two methods of research at the same time: a quasi-experiment pre- and post-test to use for comparison. Subjects were middle school girls assigned to the research program: 40 girls in the second grade, 40 girls in the third grade at K Girls' Middle School and H Girls' Middle School located in J city. The data were collected for 68 days from August 23 to October 30, 1999. The data were collected by observation technique and by a self-administered questionnaire. The instruments used for this study were as follows: the "Face Interval Pain Scale" menstrual pain instrument developed by McGreth(1987) and the "Menstrual Distress Questionnaire" dysmenorrhea instrument developed by Moos(1968). The dysmenorrhea knowledge instrument was developed by the researcher and refered to above. The research procedure was as follows: after preliminary examination, the experimental groups were provided educational programs with O.H.P. films developed by the researcher and with the videotape "first meeting" supported by P&G company and produced by EBS. The groups followed the educational programs twice for two weeks. At the beginning of menstruation, these subjects could choose one among the following choices: * Jacobson's progressively muscle relaxation method and massage treatment * Jacobson's progressively muscle relaxation method and hot bag treatment * Jacobson's progressively muscle relaxation method, a pain killer treatment, and massage treatment * Jacobson's progressively muscle relaxation method, a pain killer treatment, and hot bag treatment The dysmenorrhea of the control group were measured during the same period. The analysis of the collected data was done using an SPSS-PC+, descriptive statistic including real numbers, percentage, averages, standard deviations and t-test, $x^2$ test, and ANCOVA. The results of this study were as follows. (1) The knowledge level of the girls provided with the planned nursing intervention program was higher when compared to these who did not follow the educational programs. (2) The original difference in the dysmenorrhea level having been controled, the dysmenorrhea level made, nevertheless, a statistical difference between the experimental group and the control group(F=63.8, p=.00). Observed pain on quantity measurement of dysmenorrhea showed significant difference depending on the treatment(t=4.6, p=.00). In conclusion, those in the planned nursing intervention program had a higher knowledge level and fewer symptoms than the control group. Accordingly, the nursing intervention program for dysmenorrhea developed by the researcher can be effectively applied in nursing practice and can be the foundation for this kind of program.

• Journal of the Korean Society of School Health
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• v.16 no.2
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• pp.45-55
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• 2003

This study was focused on comparing the knowledge, attitudes and experiences in sex and the needs for sex education of nursing students and non-nursing students. The subjects of this study were 403 female students who attended 4 universities in Busan. The data was collected from November 2002 to December, and analyzed by frequency, percentage, mean, standard variance, t-test and Chi-square. The results were as follows: 1. The mean score of sex knowledge of the nursing students was 13.29 and the non-nursing students's was 11.11. There was a difference(p=0.000) between nursing and non-nursing students in sex knowledge. 2. The mean score of sex attitude of nursing and non-nursing students was 25.64, 26.65 respectively. There was no statistical difference. 3. 61.8% of the nursing students and 62.3% of the non-nursing students had experienced a relation with the opposite sex. Kissing experience was 59.9%, 61.8% and masturbation was 9.5%, 9.2% respectively. Sexual intercourse was 5.3%, 11.9% and contraception was 1.9%, 8.2% respectively. Among these experiences, sexual intercourse and contraception experience rate were different(p=0.017, p=0.002 respectively) between nursing and non-nursing students. 4. Of 19 sexual education contents, only 'the dignity of life' showed a difference. That is, more nursing students(92.9%) wanted to know about 'the dignity of life' than non-nursing students(85.7%). Among the respcndent's needs on the sexual education contents, 'Contraception' was rated first and followed by 'Sex psychology of men and women', 'Pregnancy', 'Prevention of sexual crime' and 'Sexually transmitted diseases'. Most of the respcndents(95.8%) wanted sex education introduced in the :first year of university, and presented as a special class. Specifically, 50.0% of the students wanted the education to be more realistic and systemic. With the above results, when university faculties are sexual educating to university students, they have to aware of the difference of target students. And they need to stress more realistic and specific aspect of sexual education learning rather than theoretical teaching.

• The Journal of the Petrological Society of Korea
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• v.9 no.3
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• pp.169-186
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• 2000

The Miocene volcanic rocks in the Dangsari area, eastern part of Ulsan city, are mainly composed of andesite lava flows and pyroclastic rocks. The andesite lavas are identified as two-pyroxone andesite, comprising phenocrysts of augite ($Wo_{43.2}$ $En_{41.0}$ $Fs_{15.8}$ ) and hyperthene ($Wo_{2.7}$ $65.8_{En}$ $_{Fs}$ 31.5). The andesitic pyroclastic rocks are largely composed of pyroclastic breccias with alternating tuff-breccia and lapilli tuff, which showing planar layering, and minor amount of andesitic tuff with thin deposits of interlayered tuffaceous shale. According to the petrochemical data, andesitic rocks belong to medium-K calc-alkaline andesite. The position of bulk composition on the AFM diagram and the presence of normative quartz and hypersthene indicate that the volcanic rocks are calc-alkaline. The trace element composition and REE patterns of andesite, which are characterized by a high LILE/HFSE ratio and enrichment in LREE, suggest that they are typical of continental margin arc calc-alkalic volcanic rocks produced in the subduction environment. On the discrimination diagram, the Dangsari volcanic rocks fall into the fields of subduction related continental margin arc volcanic province. The primary magic melts may be derived from about 15% partial melting of mantle wedge in the upper mantle under destructive plate margin. And the melt evolved to calc-alkaline andesite magma by fractional crystallization and the magma was a little contaminated with crustal materials.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.260-278
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• 1997

Background : Quality of professional nursing care is the most essential factor for survival and growth of nursing profession. Then, nursing professionals have responsibility for the evaluation of quality of professional nursing care. The purpose of this study was to develope an evaluation tool of nursing care for patients received gastrointestinal surgery with general anesthesia. This study was a primary work for the developement of a computer program for the evaluation of nursing care. Methods : This study was done through some consecutive steps. They were (1) Developement of items for the tool (2) Developement of an evaluation tool of nursing care quality for the G-I surgery patient (3) Test of reliability and validity of the tool. Two groups of experts and expert pannels who had much experience of the QA and the care of G-I surgery patients participated for developement of the items. 85 nursing records were used for the test of reliability and validity of the developed tool. The evaluation tools were developed with two types of scoring, norm-referenced tool and criterion-referenced tool. Results The system of items for tool was evaluation area evaluation item-indicator. There were 7evaluation areas which contained 32evaluation items which contained 7lindicators. Evaluation areas 1, 2, 3, 4 were for the evaluation of process and 5, 6, 7 were for the evaluation of outcome of nursing care for G-I surgery patient. For the test of interrator reliability, correlation coefficients of each scores of items and intragroup correlation coefficients were calculated. The average correlation coefficients between two rators were 0.65, 0.54 and the intragroup correlation coefficient were 0.99 and 1.00 by the types of scoring. The Cronbach alpha coefficients of the tools were 0.54 and 0.46 by the types of scoring. The average content validity index of the items was 0.95 from 4 pairs of experts. Because there were significant differences between some scores of quality of nursing care of 3 general hospitals regardless of the types of scoring, the tools could be thought to have some construct validity. And also, there were significant correlations between some scores of quality of nursing care and admission days and admission days after surgery regardless of the types of scoring, the tools could be thought to have predictive validity. Conclusion In this study, the evaluation tool of nursing care was developed for the very specified group of patient, G-I surgery patient. And the items were developed and tested by the experts of nursing practice. Because of these reasons, it was supposed that the tool could be used effectively in nursing pratice. And the procedures for the development and the test of the evaluation tool of nursing care in this study were supposed to be used for the developement of other tools.

• Journal of the Korean Applied Science and Technology
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• v.37 no.4
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• pp.794-806
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• 2020

This study was conducted in order to attain an in-depth understanding of and describe the Ego-Integrity Phenomenon of the elderly of age 65 and older. The data was collected from June 2020 to July 2020 as an in-depth interview consisting of semi-structured questions. The data was analyzed using the Colaizzi's method, one of the phenomenology methods. All interviews were recorded and transcribed for analysis. Through analysis, 309 significant statements were extracted, and 88 formulations of meaning, 53 themes, 16 theme clusters, and 5 categories were derived. The categories and the theme clusters are as such : 'reflecting on the past life with delight' ('fruitfulness over the lifetime', 'achieving through fulfilling responsibilities', 'achieved specially and gratefully'), 'Currently lonely and distressed due to the bitter old days' ('Physical health needs and psychosocial needs are not met', 'Wasn't able to make good choices for parents and children', 'Elderly life is not easy'), 'Satisfaction from enduring tough and difficult journeys in life' ('Compensated for hard work at workplace and home', 'Problem solved through endurance and overcoming', 'Living a healthy elderly life by escaping from the habits of the past'), 'Realizing the way of life as an elderly' ('Now is the best and most satisfying moment', 'Managing self in old age', 'Living passionately, though it may be late', 'Retiring from the forefront of life with an abundant heart'), 'Passing on beautifully' ('Desires toward the later years', 'Hope during the last moments', 'Appearance and emotions when death approaches'). It was observed that during the Ego-Integrity Phenomenon of the elderly, they have come to discern the meaning of life by reminiscing the regrets and difficulties of the past, and through this reminiscence, they have come to attain a positive and transcendental hope for the rest of their lives. The Ego-Integrity of the elderly appeared to be subjective, dynamic, and occurring simultaneously rather than continuously. It is recommended to develop a variety of nursing interventions while taking into consideration the age and the type of experience of the elderly.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.