• Title/Summary/Keyword: 분만 고위험군

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Educational Needs of Elderly Hypertensive or Diabetes Patients and Educators for Education Program Development of Cardiocerebrovascular High-risk Group (심뇌혈관질환 고위험군 교육프로그램개발을 위한 노인 고혈압·당뇨병환자와 교육자의 교육요구도 및 지식수준에 대한 비교분석)

  • Lee, Hye-Jin;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.35 no.2
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    • pp.177-192
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    • 2010
  • Objectives: This study was conducted to examine the educational needs of elderly hypertensive or diabetes patients and educators for the education program development of cardiocerebrovascular high-risk group in community. Methods: This study was conducted with 60 hypertensive or diabetes patients aged 65 years or above (cardiocerebrovascular high-risk group) who had registered KHyDDI(Korea Hypertension Diabetes Daegu Initiative) Project and attended Hypertension Diabetes Intervention Center Program, and with 44 educators in the center between June and August, 2009. Data were collected using questionnaires including general characteristics, educational objectives, curriculum, contents, and methods. Results: The major findings of this study were as follows: In education methods, cardiocerebrovascular high-risk group and educators both preferred small-grouped(5-9 persons) or individual education, 30min-1 hour, 50%-50% of theory-practice ratio, 3 months of education. In education contents, both groups needed all the suggested contents. Five categories would be suggested for the development of education program. The first category was that there was no significant difference between cardiocerebrovascular high-risk group's needs and knowledge. The second was category of low knowledge level in cardiocerebrovascular high-risk group's knowledge. The repeated education would be necessary for this category. The third was category with large standard deviation in cardiocerebrovascular high-risk group's knowledge. Individual education would be necessary for this category. The fourth category was that there was significant difference between cardiocerebrovascular high-risk group's knowledge and knowledge assessed by educators. The improvement of educator's education skill would be necessary for this category. The fifth category was that there was significant difference between cardiocerebrovascular high-risk group and educator's needs. Conclusions: Small group or individualized and staged education reflecting above cardiocerebrovascular high risk group and educators' needs should be developed for more effective education to prevent and manage the cardiocerebrovascular disease.

Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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Food and nutrient intake status of Korean elderly by degree of cognitive function (노인의 인지기능상태에 따른 식품과 영양소 섭취실태)

  • Kim, Hye-Young;Lee, Jung-Sug;Youn, Jong-Chul;Chang, Moon-Jeong
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.313-322
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    • 2016
  • Purpose: This study was conducted to examine the relationship among cognitive function, nutrition screening initiative (NSI) score, and food intake status. Methods: A total of 409 subjects aged over 60 years were recruited from the Yongin dementia prevention and control center. Mini Mental State Examination Dementia Screening (MMSE-DS) method was used to assess the cognitive function of the subjects. Information on health related behaviors and food intake was collected by face to face interview using a structured questionnaire. The questionnaires included the NSI DETERMINE checklist, food intake sheets by 24 hr recall method and by semi-quantified food frequency questionnaire. Results: Subjects were divided into low cognitive or normal groups according to the MMSE-DS result. The prevalence of low cognitive function in the subjects was 25.7%. The low cognitive group exercised less and had higher nutritional health risk than the normal group. The low cognitive group had lower consumption of polyunsaturated fatty acid and higher tendency of thiamin, riboflavin, and iron deficiency. The low cognitive group had less frequency of eating mackerel, pepper, tangerine, and watermelon and higher frequency of eating white rice and cookies than the normal group. Conclusion: The results of this study imply that the cognitive function of elderly is related to exercise behavior, nutritional health risk, and food and nutrient intake status.

Neonatal hearing screening in a neonatal intensive care unit using distortion product otoacoustic emissions (변조 이음향방사(DPOAE)를 이용한 고위험군 신생아 청각선별검사)

  • Kim, Do Young;Kim, Sung Shin;Kim, Chang Hwi;Kim, Shi Chan
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.507-512
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    • 2006
  • Purpose : Early detection and intervention of hearing impairment is believed to improve speech and language development and behavior of children. The aim of this preliminary study was to determine the prevalence of hearing impairments, and to identify the association of risk factors relating to refer response in high risk neonates who were screened using distortion product otoacoustic emissions (DPOAE). Methods : The subjects included 871 neonates who were admitted to the neonatal intensive care unit of the Pediatric Department in Soonchunhyang University Bucheon Hospital from May, 2001 to December, 2004. They were screened using DPOAE. Based on DPOAE, we divided the neonates in two groups : 'Pass' and 'Refer'. The differences in risk factors between the pass group and the refer group were analyzed. Results : The incidence of the refer group was 12.1 percent(106 out of 871). The bilateral refer rate was 5.4 percent(47 out of 871). And the unilateral refer rate was 6.7 percent(59 out of 871). Gender, birth place, family history of hearing loss, small/large for gestational age, obstetrical factor, hyperbilirubinemia and use of gentamicin were not statistically related to the refer rate. Statistically related to refer rate were birth weight, resuscitated neonates, Apgar score, craniofacial anomaly, mechanical ventilator application, sepsis, using of vancomycin(P<0.05). The prevalence of hearing impairment (${\geq}60dB$) in this study was 2 percent(18 out of 871). Conclusion : This study showed a higher prevalence of hearing impairment in high-risk neonates. Thus neonatal hearing screening should be carried out in high-risk neonates.

Periodontal Status in Accordance with the Daily Stress and Coping and Control Effect of Oral Health Behavior (일상스트레스와 스트레스 대처방식에 따른 치주상태와 구강건강행위 통제효과)

  • Kim, Eun-Sol;Choi, Eun-Mi;Han, Gyeong-Soon
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.472-480
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    • 2016
  • In this study, 110 adults aged 40 to 69 years were surveyed from April 28, 2016, to May 28, 2016 to analyze their periodontal status according to daily stress, coping methods, and oral health behavior. The collected data were analyzed using the t-test, one-way analysis of variance, and hierarchical multiple regression. Daily stress levels of all subjects were most frequent potential risk 64.5% of the subjects, the high risk 19.1% and 16.4% of the health group. Regarding stress coping methods, active methods recorded 2.46, passive methods recorded 2.32. Regarding oral health behaviors, subjects brushed an average of 2.45 times daily, for an average of 2 minutes. Futhermore, 69.1% of subjects brushed before bedtime and 89.1% practiced scaling. Regarding periodontal status, the O'Leary index was 73.45, gingivitis index was 1.30, an average of 2.83 quadrants possessed a periodontal pocket. The hierarchical multiple regression analysis identified, type of employment (${\beta}=-0.348$), scaling (${\beta}=-0.253$), and age (${\beta}=0.244$) as factors that influence the number of quadrants possessing a periodontal pocket. These results confirmed that the oral health behavior of scaling, but not stress levels of coping methods, strongly influenced periodontal status.

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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A Validity Study of the Korean Ages and Stages Questionnaires: Screening for Developmental Delay in Preterm Infant (조산아의 발달 지연 선별 검사로 사용되고 있는 ASQ의 효용성)

  • Kim, Yoon-Joo;Lee, Ju-Young;Sohn, Jin-A;Lee, Eun-Hee;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.217-223
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    • 2010
  • Purpose: To evaluate the validity of the Korean Ages and Stages Questionnaire (K-ASQ) in premature infants. Methods: Infants with a gestational age of less than 37 weeks were assessed with K-ASQ and Bayley Scales of Infant Development-III (BSID-III) at the outpatient clinic of Seoul National University Children's Hospital between October 30, 2006 and August 1, 2010. Less than 1 standard deviation of the ASQ was defined as positive, and the results were compared with those of BSID-III. Results: The mean gestational age of subjects in the study group was 28$\pm$2.87 weeks (median, 28.43 weeks; range, 23.57-35.86weeks), and the mean birth weight was 1,027$\pm$363 g (median, 950 g; range, 480-2,870 g). The sensitivity of K-ASQ at 8 month was 0.2, and the specificity was 0.93. The sensitivity of K-ASQ at 18 months was 0.72, and the specificity was 0.94. The validity of each of the 4 matched subunits was separately compared, and it also had a high specificity and a low sensitivity. In addition, KASQ showed a higher sensitivity at 18 months than at 8 months. Conclusion: ASQ was developed to screen the general population, and its specificity has been powered. The specificity was also proven in our study. The results of this study suggest that although screening use of K-ASQ in preterm infants may have some limitations, the specificities at 8 and 18 months can be clinically implicated. Further studies are needed to confirm our results.

A Kinetic Study of GaN Formation from GaOOH under $NH_3$ Flowing ($NH_3$ 분위기에서 GaOOH로부터 GaN의 반응기구)

  • 이재범;이종원;박인용;김선태
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2003.03a
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    • pp.94-94
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    • 2003
  • 최근, 새로운 전자재료로서 GaN 분말의 합성과 응용에 관한 연구가 많이 이루어지고 있다. CaN 분말은 열처리 과정 중 분해를 방지하기 위한 표면 보호용 소재, CaN 박막 또는 벌크 결정을 성장하기 위한 precursor 및 대면적 평판표시소자 제작을 위한 전기발광소자용 소재 등에 적용되고 있다. 일반적으로 100$0^{\circ}C$ 이상의 온도에서Ga과 NH$_3$를 반응시키거나, Ga이 포함된 화합물반도체 또는 산화물 및 질산염 등을 NH$_3$ 분위기에서 가열시켜 GaN 분말을 합성시키고 있다. 본 논문에서는 출발물질로서 GaOOH를 채택하고, 이를 NH$_3$ 가스를 흘리면서 가열 반응시켜 GaN 분말을 합성하고 X선 회절분석 방법을 사용하여 GaN의 합성에 대한 반응기구를 조사하였다. GaN 분말을 합성하기 위하여 GaOOH 분말 1g을 석영 용기에 담아 석영 반응관 내에 위치시키고, 반응관 내부를 $10^{-3}$ torr의 진공으로 배기한 후 $N_2$를 주입하면서 전기로의 온도를 1$0^{\circ}C$/min으로 승온시켰다. 반응온도는 300~l17$0^{\circ}C$의 범위에서 변화시켰고, 반응시간은 10분부터 24시간까지 변화시켰으며, NH$_3$의 유량은 300~700 sccm의 범위에서 변화시켰다. GaN의 반응역학을 조사하기 위하여 X선 회절도에서 특정 성분의 회절강도는 시료 내에 포함된 특정 성분의 량에 직접 비례한다고 가정하고, 2$\theta$=37$^{\circ}$부근에서 관찰되는 GaN의 (101)면에 의한 회절강도를 측정하고, 이를 GaN의 생성량으로 고려하였다.}C$로 소결 하였다. coating 결과 박리현상은 없었으나, 표면과 단면의 SEM분석결과 다소 porous한 박막층이 형성되었으며, Ca이온이 지지체로 permeation되는 현상이 발생하였다. 이와 같은 결과로부터 보다 치밀한 박막생성을 위해, slurry 제조조건을 변화시켰으며, Ca이온의 migration을 막기 위해 barrier layer를 이용하였다 완전 소결된 지지체는 가스투과도와 전기전도도측정을 통하여 특성을 평가하였다.였다.다.m이하의 NH$_3$ 가스를 검출할 수 있었다.기 화강암 관입 이전에 좌수향 전단 운동에 의해 부분적으로 재활성 되었으며, 후기 화강암의 관입 이후에 재차 우수향 전단운동으로 활성화 되었음을 알 수 있다. 이상의 결과를 종합하면 호남전단대는 쥬라기 중기에 발생한 광역적인 우수향의 연성전단운동이나, 운동 특성은 연속적이기 보다는 단속적으로 일어난 것으로 생각된다.리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비

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