• Title/Summary/Keyword: Health Care System

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A Correlational Study on ICU Nurses' Job Stress, the Way of Coping, and the Turnover Intention (중환자실 간호사의 직무스트레스와 대응방법, 이직의도에 대한 연구)

  • Cho, Yong Ae;Kim, Geum Soon;Kim, Eul Soon;Park, Han Mi;Yoo, Mi;Lim, Eun Ok;Hyun, Suk Gyung;Kim, Jung Yeon
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.129-141
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    • 2009
  • Purpose: This descriptive survey was aimed to investigate the ICU nurses' job stress, the way of coping, and the turnover intention and to identify the correlation among them. Methods: A 58 items-questionnaire composed of 7 sub-dimensions revised by Park, J. S. (2003) was used to measure the ICU nurses' job stress, and an questionnaire by Han, J. S. and Oh, G. S. (1990) which has 34 items from 6 sub-dimensions were used to measure the ICU nurses' way of coping. To figure out the ICU nurses' turnover intention, a 3 items-questionnaire used. A total of 456 nurses were participated in the study. Results: The participants' job stress was 2.86(4-point scale), and the way of stress coping was 2.27. Job stress had a positive correlation with the way of coping (r=.134, p=.004) and the turnover intention. The 54.1% of nurses addressed that they had some level of turnover intention. The turnover intention had a significant difference according to job stress(t=-2.041, p=.042), the type of hospital (${\chi}^2=8.052$, p=.005) and the total number of hospital beds (${\chi}^2=9.232$, p=.010). Conclusion: The findings of the study illustrated that the ICU nurses had at least moderate-high level of stress. The subjects' job stress showed a positive correlation with the way of coping and the turnover intention. These findings demonstrate necessity to develop an intervention for ICU nurses' stress management.

A Study on the Leisure Activation Policy Plan for Social Integration on Married Immigrant Women (결혼이주여성의 사회통합을 위한 여가 활성화 정책 방안)

  • Kim, Young-Mee;Kim, Ill-Gwang;Park, Su-Sun;Lee, Jong-Kil;Yang, Jae-Sik
    • 한국체육학회지인문사회과학편
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    • v.54 no.5
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    • pp.77-87
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    • 2015
  • This study aimed to make the leisure activation policy plan on married immigrant women for social integration of multicultural families as a social problem. For that, this study selected total 25 professional experts who can suggest leisure activation policy plans on married immigrant women with convenience quota sampling, and, they were chiefs and instructors in multicultural family support centers, professors of social welfare and leisure, and married immigrant women who had passed Test of Proficiency in Korean and been doing leisure activities. As the results, there were classified into 6 main category like established policy direction, engage, awareness, and program improvement, operations and facility improvements, administrative support, 13 middle categories, and 37 small categories. Through above process, this study suggested 6 steps of policy plan: 1st, making systematic policy direction on the base of married immigrant women's real demand, 2nd, making administrative·institutional support system for effective policy enhancement, 3rd, improving recognitions on immigrant women's leisure activity from surrounders, 4th, improving programs by efficient management and qualitative diversification, 5th, improving management of concerned facilities, and 6th, attracting participations of married immigrant women through economical support·connection and child care service.

Transcriptome Analysis of Streptococcus mutans and Separation of Active Ingredients from the Extract of Aralia continentalis (Streptococcus mutans의 전사체 분석과 독활 추출물로부터 활성 성분 분리)

  • Hyeon-Jeong Lee;Da-Young Kang;Yun-Chae Lee;Jeong Nam Kim
    • Journal of Life Science
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    • v.33 no.7
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    • pp.538-548
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    • 2023
  • The research has been conducted on the isolation of antimicrobial compounds from plant natural extracts and their potential application in oral health care products. This study aimed to investigate the antimicrobial mechanism by analyzing the changes in gene expression of Streptococcus mutans, a major oral pathogen, in response to complex compounds extracted from Aralia continentalis and Arctii Semen using organic solvents. Transcriptome analysis (RNA-seq) revealed that both natural extracts commonly upregulated or downregulated the expression of various genes associated with different metabolic and physiological activities. Three genes (SMU_1584c, SMU_2133c, SMU_921), particularly SMU_921 (rcrR), known as a transcription activator of two sugar phosphotransferase systems (PTS) involved in sugar transport and biofilm formation, exhibited consistent high expression levels. Additionally, component analysis of the A. continentalis extract was performed to compare its effects on gene expression changes with the A. Semen extract, and two active compounds were identified through gas chromatography-mass spectrometry (GC-MS) analysis of the active fraction. The n-hexane fraction (ACEH) from the A. continentalis extract exhibited antibacterial specificity against S. mutans, leading to a significant reduction in the viable cell counts of Streptococcus sanguinis and Streptococcus gordonii among the tested multi-species bacterial communities. These findings suggest the broad-spectrum antibacterial activity of the A. continentalis extract and provide essential foundational data for the development of customized antimicrobial materials by elucidating the antibacterial mechanism of the identified active compounds.

Elderly Women's Adaptation Process on Separation by Death in Rural Areas (농촌여성노인의 배우자 사별 적응과정)

  • Jang, hee Sun;Kim, Yun Jeong
    • 한국노년학
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    • v.31 no.4
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    • pp.939-967
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    • 2011
  • This study observed elderly women's adaptation process on separation by death in rural areas through grounded theory approach and developed its entity theory. Participants for this study were 14 elderly women who have lost their husbands in the last 12 months. The study was conducted for 8 months starting January 2010. Each interview per session took 40 to 90 minutes, study notes were taken on site, and recorded contents were transcribed by the researcher which was myself. The research data were collected by in-depth interview and with help of local community's nurses who were in charge of taking care of the participants. The collected data were analyzed by applying Strauss & Corbin's grounded theory (1998). As a result of study, 80 concepts, 28 subcategories, and 12 categories were deducted during open coding process. Adaptation process on separation by death was process of 'finding a way to live alone' which used strategy of 'attempting a make changes in life', and 'embracing the situation' which were influenced by conciliatory conditions of 'degree on economic condition', 'change in health', and 'supporting system' which focuses on phenomenon of 'bearing life alone' which is influenced by context condition of 'marital chemistry of couples during lifetime', and 'the couple's leadership during lifetime' together with casual conditions of 'the fall of wall'. The adaptation process accordance to time flow were divided into 4 steps which were step of 'shock and release of emotions', step of 'longing and resentment', step of 'resignation and acceptance', and step of 'life's restructure'. Above results suggest right directions for welfare for the aged and process of 'finding a way to live alone' for participants by controlling several factors and using intervention strategy, and provided basic data required for developing and applying practical welfare mediation.

Effect of Stent Placement on Survival in Patients with Malignant Portal Vein Stenosis: A Propensity Score-Matched Study

  • Dong Jae Shim;Jong Woo Kim;Doyoung Kim;Gi-Young Ko;Dong Il Gwon;Ji Hoon Shin;Yun-Jung Yang
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.68-76
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    • 2022
  • Objective: Percutaneous portal vein (PV) stent placement can be an effective treatment for symptoms associated with portal hypertension. This study aimed to evaluate the effect of PV stenting on the overall survival (OS) in patients with malignant PV stenosis. Materials and Methods: Two groups of patients with malignant PV stenosis were compared in this retrospective study involving two institutions. A total of 197 patients who underwent PV stenting between November 2016 and August 2019 were established as the stent group, whereas 29 patients with PV stenosis who were treated conservatively between July 2013 and October 2016 constituted the no-stent group. OS was compared between the two groups before and after propensity score matching (PSM). Risk factors associated with OS were evaluated using the Cox proportional hazards model. Procedure-associated adverse events were also evaluated. Results: The stent group finally included 100 patients (median age, 65 [interquartile range, 58-71] years; 64 male). The no-stent group included 22 patients (69 [61-75] years, 13 male). Stent placement was successful in 95% of attempted cases, and the 1- and 2-year stent occlusion-free survival rate was 56% (95% confidence interval, 45%-69%) and 44% (32%-60%), respectively. The median stent occlusion-free survival time was 176 (interquartile range, 70-440) days. OS was significantly longer in the stent group than in the no-stent group (median 294 vs. 87 days, p < 0.001 before PSM, p = 0.011 after PSM). The 1- and 3-year OS rates before PSM were 40% and 11%, respectively, in the stent group. The 1-year OS rate after PSM was 32% and 5% in the stent and no-stent groups, respectively. Anemia requiring transfusion (n = 2) and acute thrombosis necessitating re-stenting (n = 1) occurred in three patients in the stent group within 1 week. Conclusion: Percutaneous placement of a PV stent may be effective in improving OS in patients with malignant PV stenosis.

Database for Hospice Nursing in Electronic Medical Record (호스피스 전자기록을 위한 데이터베이스 개발)

  • Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.200-213
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    • 2004
  • Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

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Community Dwellers' Perception of Past Life Recollection and Preparation for Death (서울시 일 지역 주민의 인생회고 및 죽음준비 인식)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.81-90
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    • 2011
  • Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.

The 1998, 1999 Patterns of Care Study for Breast Irradiation after Mastectomy in Korea (1998, 1999년도 우리나라에서 시행된 근치적 유방 전절제술 후 방사선치료 현황 조사)

  • Keum,, Ki-Chang;Shim, Su-Jung;Lee, Ik-Jae;Park, Won;Lee, Sang-Wook;Shin, Hyun-Soo;Chung, Eun-Ji;Chie, Eui-Kyu;Kim, Il-Han;Oh, Do-Hoon;Ha, Sung-Whan;Lee, Hyung-Sik;Ahn, Sung-Ja
    • Radiation Oncology Journal
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    • v.25 no.1
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    • pp.7-15
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    • 2007
  • [ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

Consumer Perceptions of Food-Related Hazards and Correlates of Degree of Concerns about Food (주부의 식품안전에 대한 인식과 안전성우려의 관련 요인)

  • Choe, Jeong-Sook;Chun, Hye-Kyung;Hwang, Dae-Yong;Nam, Hee-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.1
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    • pp.66-74
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    • 2005
  • This survey was conducted to assess the consumer perceptions of food-related hazard in 500 housewives from all over Korea. The subjects were selected by stratified random sampling method. The survey was performed using structured questionnaire through telephone interview by skilled interviewers. The results showed that 34.6% of the respondents felt secure and were not concerned about food safety, and 65.4% were concerned about food safety. Logistic regression analysis showed that the increasing concern on food brands, food additives (such as food preservatives and artificial color), and imported foodstuffs indicated the current increasing concern on food safety. Other related factors indicating the increasing concern on food safety were education level and care for children's health. The respondents who cared about food safety expressed a high degree of concern on processed foodstuffs such as commercial boxed lunch (93.3%), imported foods (92.7%), fastfoods (89.9%), processed meat products (88.7%), dining out (85.6%), cannery and frozen foods (83.5%), and instant foods (82.0%). The lowest degree of concern was on rice. All the respondents perceived that residues of chemical substances such as pesticides and food additives, and endocrine disrupters were the most potential food risk factors, followed by food-borne pathogens, and GMOs (Genetically Modified Organisms). However, these results were not consistent with scientific judgment. Therefore, more education and information were needed for consumers' awareness of facts and myths about food safety. In addition, the results showed that consumers put lower trust in food products information such as food labels, cultivation methods (organic or not), quality labels, and the place of origin. Nevertheless, the respondents expressed their desire to overcome alienation, and recognized the importance of knowing of the origin or the producers of food. They identified that people who need to take extreme precautions on food contamination were the producers, government officials, food companies, consumers, the consumer's association, and marketers, arranged in the order of highest to lowest. They also believed that the production stage of agriculture was the most important step for improving the level of food safety Therefore, the results indicated that there is a need to introduce safety systems in the production of agricultural products, as follows: Good Agricultural Practice (GAP), Hazard Analysis and Critical Control Point (HACCP), and Traceability System (75).

A Clinicostastical Analysis of Genitourinary Diseases from the Nationwide Hospital Discharge Survey (전국 퇴원환자 자료분석을 통한 소아 청소년의 비뇨생식기질환의 분포)

  • Kim, Sa-Ra;Park, Hyun-Ju;Moon, Jin-Soo;Lee, Chong-Guk
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.63-74
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    • 2009
  • Purpose : The current nationally representative data on inpatient care are important to make the of the national public health policy because distributions and the prevalence of diseases among children and adolescents represent the socioeconomic status of the society. The prevalence of chronic disease is increasing now in Korea as the socioeconomic condition is improving. We analyzed a part of genitourinary tract disease of the cross-sectional hospital discharge survey data in Korea collected recently to delineate the trend of genitourinary tract diseases. Methods : Korean nationwide hospital discharge survey for pediatric inpatients in the period from 2004 to 2006 was analyzed. Diagnoses in the data were coded using ICD-10 classification. Totally 826,896 cases were collected from the 85 training hospitals. Selected data of genitourinary tract diseases (belonging to N00-N99 by ICD-10) among 826,896 cases of final inpatients data were analyzed for this study. Results : Among total patients of 826,896, diseases of the genitourinary system accounted for 4.1%. and four diagnostic categories accounted for 92.8%. These were other diseases of the urinary system (N30-39), 45.8%, disease of male genital organs (N40-51),19.1%, glomerular diseases (N00-08), 17.3%, renal tubulo-interstitial diseases (N10-16), 10.6%, respectively. Conclusion : Genitourinary tract disease in pediatric inpatient shows decreasing tendency but the prevalence of chronic diseases is increasing in Korea as the socioeconomic condition is improving. For further comprehensive analysis, regular and organized nationwide survey should be performed. Development of a new data collecting system will improve the performance of such nationwide survey.