• 기본간호학회지
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• 제23권3호
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• pp.245-255
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• 2016

Purpose: This study was conducted to compare self-care behaviors and self-care behavior related factors for groups of patients with good, inadequate and poor glycemic control. The study was based on variables of the Theory of Planned Behavior by Ajzen, habit and family support. (1991). Methods: Participants were 134 patients with type 2 diabetes (good glycemic control group: 57, inadequate glycemic control group: 40, poor glycemic control group: 37). Self-care behaviors, intention to self-care behavior and self-care behavior related variables (attitude, subjective norms, perceived behavior control, habits and family support) were measured. Data were collected from August 12 to September 25, 2014 and were analyzed using $x^2$-test, Fisher's exact test, ANCOVA, and logistic regression with SPSS/WIN 21.0. Results: Among the three glycemic groups, there were significant differences in self-care behavior, subjective norms, perceived behavior control, family support, and habits. Multinomial logistic regression showed that poor blood glucose probability was associated with duration of diabetes mellitus, method of DM therapy, perceived behavior control and habits. Conclusion: The study findings reveal the important role of self-care behavior, subjective norms, perceived behavior control, family support, and habits in blood glucose control in adults with type 2 diabetes.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.716-720
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• 2015

Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis.

• 부모자녀건강학회지
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• 제15권2호
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• pp.71-79
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• 2012

Purpose: This study was conducted to examine the effects of simulation-based practice using standardized patients for the care of woman with postpartum hemorrhage as related to clinical performance competence and critical thinking deposition of nursing students. Methods: A nonequivalent control group pre-post test experimental design was used. Fifty four third year students were recruited, 29 students for the experimental group and 25 students for the control group. The simulation-based practice about nursing care related to postpartum hemorrhage included skill training, team-based practice, and debriefing. It was implemented with the experimental group for about 30 minutes in October 6, 2011. Data were analyzed using frequency, ratio, chi-square, Fisher's exact probability, and t-test using the SPSS/WIN program. Results: The experimental group who had the simulation-based practice showed significantly higher knowledge and skills of clinical performance competence than the control group (t=2.19, p=.003). But the experimental group who had the simulation-based practice did not show significantly higher critical thinking deposition than the control group (t=-0.32, p=.748). Conclusion: The results indicate that a simulation-based practice is an effective teaching method to improve knowledge and skills for clinical performance competence of nursing students. Further study is needed to identify the effect of a simulation-based practice on nursing attitudes.

• 한국보건간호학회지
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• 제5권2호
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• pp.67-75
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• 1991

This study was conducted to evaluate the difference of staphylococcal colonization between lactating mothers and nursery stares. Samples were obtained from the hands and noses of the newborn(admitted to S Univ. hospital's nursery from 1991. 5. 23 to 6. 8), their mothers and nursery staffs. They were cultured, and then the presence/absence of pathogenic staphylococci in them were analyzed by Fisher exact probability test which led to these conclusion of significance as follows: 1. No differences were detected in pathogenic rate of nasal swab culture between breast~fed newborns and formula-fed ones. 2. Delivery type and hospitalization the ones from the brest-fed newborns show high rate of Sta. aureus coa(+). In case of either C-sec delivery or long (more than 4 days) hospitalization, formula-fed ones in case of NSVD or short (less than 3 days) hospitalization. 3. The ones from breast feeding mothers show higher sta. aureus coa(+) than those from nursery staffs, which was of no significance statistically. Considering nursery staffs only, however, the comparison of those with the data in April indicates that the pathogen rate is higher for hand than nose, and Sta aureus coa(+) for hand is far lower in June than in April, which was statistically significant. These results lead us to infer that newborn infection in hospitalization could be largely reduced by maintaining the ordinary hygienes. Such as the handwashing of mothers as well as nursery staffs (directly involved in newborn care) Thus the pre-enterance hand washing of a mother who visits the nursery only for breast feeding (without any other medical responsibility) should be done, like other medical agents, with $0.05\%$ chlorhexidine antiseptics rather than simple soap cleansing; the one 'that is worth emphasizing thoroughly.

• Radiation Oncology Journal
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• 제25권4호
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• pp.261-267
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• 2007

목적: 방사선 폐렴과 체적-선량 히스토그램(dose-volume hlstogram, DVH) 변수들 사이의 연관성을 평가하고, 내유림프절이 포함된 유방암의 방사선치료에서 방사선 폐렴을 방지할 수 있는 실제적인 지침을 제공하고자 한다. 대상 및 방법: 부분유방절제술을 받은 초기 유방암 환자 20명이 본 연구에 포함되었다. 전체 유방, 상부쇄골림프절, 내유림프절에 총 28회 50.4 Gy가 조사되었다. 방사선 폐렴은 방사선 영상에서의 폐 변화(radiological pulmonary change; RPC)와 증상이 있는 방사선 폐렴(symptomatic radiation pneumonitis)에 의해 평가되었다 DVH 변수들은 grade<2 RPC와 grade${\geq}$2 RPC로 나누어 비교되었다. 이 때, DVH 변수들은 평균 폐 선량(mean lung dose), V10 (10 Gy 이상 받는 폐의 백분율 부피), V20, V30, V40, 그리고 정상 조직 합병증 확률(normal tissue complication probability, NTCP)이다. 결 과: 20명의 환자 중 9명(45%)에서 grade 2 RPC가 발생하였고, 11명(55%)에서는 발생하지 않았다 1명의 환자에서 grade 1의 증상이 있는 방사선 폐렴이 발생하였다. 단변량 분석에서 DVH 변수 중, NTCP가 두 RPC grade군 간에 유의한 차이를 보여주고 있다 (p<0.05) Fisher의 정확한 검증(exact test)은 NTCP값 45%가 RPC의 threshold level로서 적합함을 보여준다. 결 론: 본 연구는 NTCP가 유방암의 내유림프절 방사선치료 후 RPC 예측인자 중 한가지로 쓰일 수 있음을 보여준다. 임상적으로 이는 NTCP 45% 이상에서 RPC가 발생하기 용이함을 의미한다.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5882-5892
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• 2012

본 연구는 단전호흡 프로그램이 혈액투석환자의 스트레스, 수면장애 및 자아존중감에 미치는 효과를 규명하여 간호중재로서의 가능성을 검증하고자 시도하였다. 연구는 비동등성 대조군 전-후 설계의 유사실험연구(quasi-experimental design)로, 대상자는 J도에 소재한 2개 의료기관에서 주 1회 이상 혈액투석을 받고 있는 환자로서, 실험군 18명과 대조군 19명을 편의표집하였다. 실험처지는 단전호흡 프로그램을 1회 60분씩, 주 2회, 12주간 실험군에게 적용한 결과, 단전호흡 프로그램을 실험처치한 실험군에서는 대조군보다 스트레스(t=-2.95, p=.006)와 수면장애(t=-2.13, p=.041) 정도가 통계적으로 유의하게 감소하였고, 자아존중감(t=2.44, p=.020) 정도는 통계적으로 유의하게 증가하였다. 따라서 단전호흡 프로그램은 만성질환자인 혈액투석환자의 스트레스와 수면장애를 개선할 수 있고, 자아존중감을 향상시킬 수 있는 간호중재로 활용될 수 있을 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제44권6호
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• pp.1296-1307
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• 1997

연구배경 : Erdosteine은 만성 기관지염 급성 악화시는 물론 만성 폐색성 기관지염 치료제로 개발된 Thiol 유도체로서 점액조절작용, 항산화작용이 있으며, 특히 위장관 부작용이 거의 없다. 본 연구에서는 현재 유효성 및 안전성이 입증되어 임상에서 많이 처방되고 있는 Ambroxol과의 비교임상연구를 통해 급성 및 만성 기관지염 환자에서 Erdosteine의 임상적 유용성을 알아보고자 하였다. 방 법 : 본 연구는 무작위 이중맹검 비교시험으로서 전향적 연구방법으로 수행되었다. 급 만성 기관지염으로 다량의 객담배출 혹은 객담배출곤란을 주증상으로 하는 80명을 무작위로 할당하여 Erdosteine 투여군에는 1일 2회, 1회 300mg, Ambroxol 투여군에는 1일 2회, 1회 30mg을 총 7일간 투여하였다. 1차 효과평가기준으로는 객담배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도, 호흡곤란을 포함한 자각증상이 평가되었고, 2차 효과평가기준으로는 동맥혈가스검사, 폐기능검사가 평가되었다. 안전성은 부작용과 임상병리검사로 평가하였다. 총 80명의 환자 중 61명(Erdosteine군 : 31명, Ambroxol군 : 30명)이 본 연구를 종료하였고 19명은 중도 탈락되었다. 결과의 분석은 paired t-test, ANOVA test, multivariate t2-test, Repeated measures analysis of covariance, two sample t-test, Loglinear-Logit model analysis, Fisher's exact test를 이 용하여 유의성을 검정하였다. 결 과 : 1) 두 군간의 환자배정에 있어서 인구학적, 임상적 특징은 차이가 없었다. 2) 동맥혈가스검사, 폐기능검사에서는 두 군간의 차이는 없었고, 자각증상에서는 Erdosteine군은 객담 배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도, 호흡곤란에서, Ambroxol군은 객담배출횟수, 객담량, 객담배출용이도, 객담점도, 기침정도에서 유의하게 호전을 보였다. 통계적으로 유의하지 않았으나 Erdosteine군이 Ambroxol군에 비해 더 유의하게 호전되는 경향을 보였다($\alpha$=0.05). 3) 혈액학적검사, 혈액화학적검사 및 소변검사에서는 각 군 모두 임상적으로 의미있는 변화는 없었고 두 군간의 차이도 없었으며, 자각증상에서는 Ambroxol군에서만 4명이 연구 종료시까지 부작용이 소실되지 않았고 2명은 연구를 중단하였으나 두 군간의 차이는 없었다. 4) 각 약제의 최종효과평가에서 Erdosteine군은 31명 중 아주좋은효과 11명, 좋은효과 12명, 경도효과 6명, 무효과 2명, 악화 0명이었고 Ambroxol군은 30명 중 아주좋은효과 6명, 좋은효과 14명, 경도 효과 5명, 무효과 4명, 악화 1명이었으며 Erdosteine군이 Ambroxol군에 비해 증상이 개선될 확률이 약 2.5배만큼 높았다 (p<0.05). 결 론 : Erdosteine은 급성 및 만성 기관지염 환자의 치료에 있어 그 효과와 안전성에 있어서 우수한 약물이라고 할 수 있다.

• 농촌의학ㆍ지역보건
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• 제34권1호
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• pp.124-134
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• 2009

본 연구는 건강증진 시범사업을 수행하는 보건소와 자체 예산으로 건강증진 사업을 수행하는 보건소간 주민의 건강증진 생활 형태의 차이를 대표성있는 대상자를 선정하여 비교하고자 하였다. 대상은 지난 2004년 1년간 건강증진 시범사업 실시 지역 1개 군(H 군)과 비 실시 지역 1개 군(J 군)을 임의표집하고, 2개 군에 주소를 둔 20세 이상 주민 전체 중 연령별, 남녀별, 읍면별로 인구분포 수에 따라 층화비율 표집을 하여 총 1,300명을 추출하였다. 자료는 훈련받은 조사원이 젊은이는 자가보고식으로 노인은 면접법으로 수집하였고 도구는 한국판 BRFSS설문지를 수정보완하고, 보건복지부의 식생활자가점검표, 박순영이 개발한 스트레스 측정도구의 설문지를 이용하였으며, 두 지역 주민의 건강증진 생활행태를 차이를 x2-test와 Fisher's exact probability test로 비교하였다. 연구결과, 보건복지부 지원의 건강증진 시범사업지역 주민이 더 건강하다고 생각하고, 흡연율, 음주관련 생활행태가 모두 좋았으며 규칙적 운동율도 높았고, 스트레스도 유의하게 낮아 정부 지원건강증진 사업이 효과적이라고 나타났다. 이는 건강증진 5대 요소를 모두 포괄하는 사업계획을 하였으며, 타 보건소와의 경쟁을 통해 사업지역으로 선정되고, 사업 종료 후 내외부 평가 기준과 지침이 명확하며, 사업비 지원이 중요요인으로 작용하였다고 본다. 본 연구 결과를 토대로 다음과 같이 제언하고자한다. 1) 다년간 건강증진사업 시범지역과 비시범지역의 차이를 비교하는 반복연구가 필요하다. 2) 건강증진생활 행태를 중심으로 대도시, 도농복합도시 및 농촌의 건강증진 사업 효과를 비교할 필요가 있다.

• 한국치위생학회지
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• 제9권4호
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• pp.715-725
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• 2009

Objectives : The purpose of this study was to analyze the influence which the professional dental hygiene education has on the knowledge and behavioral change for oral health to the students in the departments of dental hygiene. Methods : 771 students in the first grade and 646 students in the third grade who were attending the departments of dental hygiene from 12 colleges in Korea were surveyed. The self-administered questionnaires were distributed to the students in the colleges during May and asked them to answer the questions and then recovered them on the spot. The collected questionnaires were analyzed by using a SPSS/PC program and the difference of significance depending on the group of the students was tested by Chi-square test or Fisher's exact probability test. Results : In the number of eating snacks by the students during one day, 2-3 times was the highest, irrespectively of the grade. The rate of the students brushing their teeth after snack was higher in the third-grade students(34.8%) than in the first-grade students(20.8%). As the path of acquiring oral health knowledge, all of the first-grade and third-grade students replied that their school classes had impacted them the most. The rate of toothache experience was a higher tendency in third-grade students compared to the first-grade students(p=0.116). The rate of gingival bleeding experience was lower in the third-grade students than in the first-grade students. The rate of oral prophylaxis experience was higher in the third-grade students than in the first-grade students. In the smoking rate, there was lower in the third-grade students than in the first-grade students. The rate of acknowledging smoking hazard to the periodontal health was higher in the third-grade students than in the first-grade students. Conclusions : This study revealed that the third-grade students of dental hygiene departments who were majoring in dental hygiene had a higher perception of oral health than the first-grade students whose the dental hygiene education period was short.