• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.581-596
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• 1995

Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

• Journal of dental hygiene science
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• v.2 no.2
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• pp.89-94
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• 2002

The present study attempts to find the ways to efficiently manage dental caries, one of the major causes of tooth loss, and to cope with oral diseases that deteriorate oral health. For this purpose, this study seeks to obtain fundamental data needed in planning the oral health projects. The study was conducted to the first-grade elementary school students in Hwa-Seong city, Gyeonggi-do, from April 1 - 30, 2002. The result was as follows: 1) Among a total of 2,710 subjects, 598 (274 boys and 324 girls) have more than 1 permanent tooth with a caries legion whether it was treated or not. 2) The number of permanent teeth examined is 6,029, in which girls' teeth are more (3,165) than boys' (2,864). 3) Out of a total of 6,029 teeth examined, 1,106 permanent teeth (508 boys' and 598 girls') have caries legions. 4) Out of 1,106 permanent teeth with caries legions, 170 (15.4%) were treated - 67 teeth for boys (13.2%) and 103 teeth for girls (17.2%). 5) 22.1% of the children have experienced dental caries in their permanent teeth. Among them, 20.1% are boys and 24.1% are girls. 6) The rate of the permanent teeth that once had, or now have caries legions are 21.2%, among which the rate for boy's teeth is 20.1% and that for girl's teeth is 22.1%. 7) The number of the permanent teeth that had caries legions is 0.5 for all the subjects. A boy has 0.4 and a girl has 0.5 teeth with caries legions regardless of whether it was treated or not. 8) The rate of the permanent teeth with caries legions is 86.7% for overall subjects - 88.3% for boys and 85.3% for girls. 9) The rate of treated permanent teeth is 13.3% for all the subjects - 11.7% for boys and 14.7% for girls. Based on the above result, the study draws a conclusion that in order to prevent dental caries in young students and to perform an early treatment for the dental caries that already occurred an oral health office should be installed at all the elementary schools so that elementary school students don't experience a loss of time and effort for learning and suffer nutritional imbalance or disorder. Besides, the oral health education concerning the importance of dental care should be conducted to the citizens, especially to the young people, in the community as an essential project of oral health centers in the community health offices, the public medical institutions.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.91-95
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• 2004

This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.101-111
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• 2005

Objectives: This study was to evaluate the compliance of hypertensive patients and its related factors registered at Community Health Practitioner Post(CHCP). Methods: 304 patients were interviewed by trained nursing students during one month(June~July 2004). The questionnaire included general charactristics, knowledge of hypertension, health education experience, constructs of Health Belief Model, self efficacy and so on. Compliance group was defined "having regularly medication and good life style". Good life style included regular exercise, non-smoking, little alcohol, low salt diet, weight control. Results: In compliance group 90.3% of man and 93.3% of woman were regularly taking hypertensive medicine, and 45.2% of man and 56.4% of woman were having good life style (compliance group). In both man and woman, the group of higher education were more compliance group, but were statistically significant were in man(p<0.05). In woman, the compliance group have significantly higher score in knowledge of hypertension(p(0.05). The compliance group have significantly higher self-efficacy score in both man and woman (p<0.05). In Health Belief Model, susceptibility and benefit were statistically significant in man, seriousness, benefit and barrier in woman(p<0.05). In multiple logistic regression analysis, education level and self efficacy in man and knowledge of hypertension, self-efficacy and benefit in woman were significant variables (p<0.05). Conclusions: It is very important to evaluate and modify life-style adding to having regularly medication in hypertensive patients registered at CHCP. To this, health education programs about benefit to compliance and the methods to improve self-efficacy should be developed for this patients.

• Journal of the Korean Institute of Landscape Architecture
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• v.42 no.6
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• pp.10-20
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• 2014

Today, most roof spaces are being designed as places for resting. The use of the roof spaces needs to be raised otherwise, budgeting or costs involved can be wasteful. A well-made plan is needed to increase the use of the roof spaces. The behavior of and preference for roof spaces could differ depending on building usage because the users of these roof spaces can be different. Therefore, this study selected 4 building types depending on usage: public buildings, educational and research buildings, medical buildings, and commercial buildings. Two buildings that created roof spaces per building type were selected. A survey was undertaken of the user experience of roof spaces on the buildings. The behavior and preference of roof spaces depending on building types were analyzed and the results are as follows. The behavior of using roof spaces regarding purpose, motivation, frequency, and average length of stay were different depending on the building types. In terms of purpose, over all four building types, taking a rest was the primary reason for using roof spaces. However, talking and smoking in public buildings, smoking, taking a walk or stretching, and viewing the exterior landscape in educational and research buildings, taking a walk or stretching and talking in medical buildings, taking care of children and talking in commercial buildings were also important reasons for using roof spaces. The preference of roof space components such as plants, paving materials, and facilities were different depending on the building types. In terms of plants, the users of public buildings preferred herbaceous plants and vegetables/aquatic plants more than the users of other building types. The users of medical buildings preferred vegetables/aquatic plants, and the users of commercial buildings preferred arbores, herbaceous plants, and vegetables/aquatic plants more than the users of other building types. This study provides empirical data for the behavior and the preference of roof spaces depending on building types. These findings could provide new insights into how to increase the use of roof spaces.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.466-471
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• 1998

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.275-280
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• 2006

Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.389-397
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• 1989

To identify the problems in child rearing practice of employed mothers in urban poor area, all of 201 women with children under 6 years old living in Yun San 3 Dong, a poor area of Pusan city, were interviewed with a questionnaire by a trained interviewer from 10th April to 10th May 1989. Among 201 women, 51 women were employed and 150 women were unemployed. Of the employed mothers 78.5% got their jobs because of economical need and 31.4% of them worker for 60-69 hours per week. Their average monthly income was 100,000-190,000 Won in 33.4% and 200,000-290,000 Won in 25.4% Breast milk was fed in 66.0% of the children of unemployed mothers while 49.0 of the children of the employed mothers were breast-fed (p<0.05). The most common reason for not breast feeding was shortage of breast milk among unemployed mothers (58.9%) but that of the employed mothers was their job(63.6%). The basic immunization for children was completed in 70.5% of children of employed mothers as compared with 82.0% of the children of the unemployed mothers were completely immunized (p>0.1). Accident experience rate of children among the employed mothers was 23.5 a and that of the children of the unemployed mothers was 17.3% . The most common cause of acident in children of the unemployed mothers was carelessness while they were playing(34.6%) but in children of the employed mothers it was traffic accident(25.0%) and falling(25.0%). Most of the traffic accidents took place while the children's brother or sister of age under 14 years were baby sitting. When the accident took place 73.1% of the unemployed mothers were just at home, but 58.3% of the employed mothers were out of home for work. In case of the employed mothers, 58.7% of their children were looked after by an adult mainly grandparents, 15.7% by the children's brothers and sisters under 14 years old, and 3.9% of the children were left alone. A majority of the unemployed mothers wanted to get a job if someone could take care of their children. To facilitate the women employment and for the safety and health of the children, good nurseries for working mothers need to be established at a cost they can afford.

• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

• Korea journal of population studies
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• v.11 no.1
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• pp.159-184
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• 1988

Race and ethnicity are important factors which influence the elderIy's residential adjustment behaviors, although it is unclear whether this reflects influences unrelated to race and ethnlcity. Culturally, the norm of family supportoften obseved among various minority ethnic groups is likely to provide flexible family suppof for the elderIy. Economically, the life-long hardship ofminority groups is likely to force them to maintain extended family living arrangements simply to reduce expenses via economies of scale. Thecontroversy about the economic need versus the cultural prescription forextended living arrangements remains unresoIved because it fails to articulatethe meaning of family supports among many disadvantaged groups.This study aims to test previous economic and cultural arguments, byexamining ethnic differences iu the eiderIy's responsiveness to their health andeconomic problems. Two hypotheses about cultural influences on the elderly's resideutiai adjustment are examined. First, do elderly minorities receive famiiysupporis for longer periods when they are poor if economic and health status\ulcorner Second, do elderiy minorities receive family supports more often when their health status declines\ulcorner Using the Longitudinal Suvey on Aging from 1984 to 1990. this study employs Markovian multi-state life tables, and discrete and contonuous competing hazard analyses for the transition in living arrangements. The main results provide substantial evidence against the cultural resource thesis. Elderly minorities experience more frequent transition between living alone and living with relatives than white elderly persons when group differences in the extent of mortality and insititutionalization are controlled. The shorter timf of living alone among elderly monorities stems from their greater likehood of joining relatives as well as greater mortality and attrition rates than elderly whites. Coresidence of elderly whites with their relatives is more likely to occur in response to their needs for health care than of elderly whites. it implies that instability. not flezibility. characterrizes elderly minorities living arrangements.