• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Korean Journal of Schizophrenia Research
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• v.20 no.2
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• pp.55-60
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• 2017

Objectives : Severe mental illness is a major risk factor for suicide. This study aimed to identify characteristics of patients who died by suicide among subjects who had been received service from a community mental health center. Methods : We searched individuals who had committed suicide in Gwangju Bukgu Community Mental Health Center since 2006. Sociodemographic and clinical data were gathered from medical records and their case managers and they were compared with those of general members in the center. Characteristics of schizophrenia patients who died by suicide were particularly summarized. Results : Twelve person committed suicide between 2006 and 2016. The characteristics of those who died by suicide were male (67%), diagnosis of schizophrenia (75%), aged below 50 (83%), unemployed (92%), past history of psychiatric hospitalization (100%), recent admission within 3 months (67%), past history of suicidal attempt (78%), family history of schizophrenia (58%), poor adherence to medication (58%), and use of daily rehabilitation program (42%). Ten out of twelve (83%) showed warning sign for suicide. All identified method of suicide in patients with schizophrenia was jumping from high building. Many patients with schizophrenia, who committed suicide, suffered from comorbid depressive symptoms (67%) and auditory hallucination (78%). Conclusion : Case managers should pay attention to and carefully manage individuals who showed suicidal warning, particularly with risk factors for suicide, such as unemployment, admission state or recent discharge from psychiatric hospital, poor adherence to medication, family history of schizophrenia, and a history of suicidal attempt.

• Journal of Korean Academy of Nursing
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• v.8 no.1
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• pp.131-138
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• 1978

The change of society has brought about various health problems which have become to demand comprehensive health services not only for individuals but also for families and communities as the unit. To meet the societal needs W Hospital in a rural Korea established a Department of Community Health Nursing Services and provided nursing services to patients under a early discharge program. This study is to evaluate the community health nursing services carried out the department in general, and has following specific objectives : 1. To learn attitude of the consumers and the "referees" toward early discharge program. 2. To find out attitude toward home care and cure services. 3. To find out the consumers and the "Referees" attitude toward the 15 selected home cue and cure activities by public health nurse. 4. To investigate possibility of charging fee for the 15 selected home care and cure activities by public health nurse. Three different study population were chosen: namely the consumer, the "referee" I and II. Excluding families moved out and not able to be contacted, the total families (77) referred to the department during the study period of September 1974 - December 1975 are defined as the consumer. Thirty seven nurses among 81 nurses who have been working in W Hospital since the inception of the Community Health Nursing Service Program were randomly selected. Thirty two nurses were defined as the "referee"I, because 5 questionnaires were not able to be collected. Twenty four doctors out of 37 who have been working since the Community Health Nursing Service Program started, and who were able to contact were called as the "referee" II. Data collection method employed for the consumers was direct interviewing with preposed interview schedules, and for the "referees"questionnaire method was utilized. x$^2$test and 100-percentage were employed in analyzing the data. The study findings are follows: 1. Attitude toward early discharge: Above 85% of the consumers and the "referees" approved the early discharge: Above 85% of the consumers and the "referees" approved the early discharge program. 2. Attitude toward the home care and cure services: Above 75% of the consumers and the "referees" showed positive attitude toward the home care and cure services by public health nurses. 3. Attitude toward 15 selected home care and curative activities by public health nurses: On the average more than 50% of the consumers and the "referees" expressed an affirmative attitude to perform 15 selected home care and cure services by public health nurses. 4. Attitude toward charging fee for 15 selected home care and curative activities by public health nurses: Above 85% of the consumers thought that they would pay for the services. Only 12.8% of the consumers and 5% of the "referees" what to have the services for nothing. Based upon the findings of this study; That is, the home care and cure services to be given by public health nurse were positively responded by the consumers and the pro-fissionable, one can conclude that the services provided by the Department of Community Health Nursing Service of W Hospital have been well accepted, and that early discharge program of hospital is believed to be a means to lessen the expenses of patients from hospitalization and to promote recovery from illness. It is recommended that hospital centered cure services should be reconsidered and scrutinized to meet community health needs. NOTE : "referees" are nurses and doctors who refer the early discharged Patient to the Department of Community Health Nursing Service.

• Journal of the Society of Disaster Information
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• v.7 no.4
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• pp.266-272
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• 2011

This study is focused on guard major collegians who are composed of factor in medical emergency system. In the case of cardiac failure, it is to make its basic data develop its education program of CPR which can increase the patient's survival rate before his hospitalization. The subject of study is composed of 120 persons who are 94 boy-collegians(78.3%) and 26 girl-collegians(21.7%) in sex and 66 first-grade collegians(55.0%) and 54 second-grade collegians(45.0%) in a school year. There is significant difference in the practices of artificial respiration and the thorax pressure after the education of basic CPR in sex(p<0.01). The practices of artificial respiration in boy-collegians($93.72{\pm}4.21$) is higher than in girl-collegians($82.31{\pm}6.36$) and the practices of thorax pressure in boy-collegians($92.45{\pm}4.44$) is higher than in girl-collegians($88.08{\pm}6.49$). The satisfaction degree of boy-collegians($4.33{\pm}0.59$) is higher than that of girl-collegians($3.73{\pm}0.67$) after theory & practice education of basic CPR(p<0.01). It is necessary to develop the education program and educate its knowledge & technology in proportion to collegians characteristics of sex and school year. Also, education authorities should develop a subject of the accident provided the practical education of CPR for guard major collegians.

• Child Health Nursing Research
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• v.6 no.1
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• pp.32-50
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• 2000

A descriptive exploratory design was used in this study to evaluate the effects of sponge bathing on physiological(heart rate, heart period, vagal tone, oxygen saturation, respiration) and behavioral responses in newly born 40 preterm infants from intensive care unit of S University Hospital in Seoul. Data has been collected from October, 1997 to March, 1999. The infants were between 27-33 weeks gestational age at birth, and were free of congenital defects. The subjects entered the protocol when they were medically stable (determined by initiation of feeding and discontinuation of all respiratory support) but still receiving neonatal intensive care. The infants' physiologic parameters were recorded a 10 - minute before, during, and after bathing. Continuous heart rate data were recorded on a notebook computer from the infant's EKG monitor. The data were digitized off-line on software(developed by Lee and Chang in Wavelet program) which detected the peak of the R wave for each heart beat and quantified sequential R-R intervals in msec(i.e. heart periods). Heart period data were edited to remove movement artifact. Heart period data were quantified as : 1) mean heart period; 2) vagal tone. Vagal tone was quantitfied with a noninvasive measure developed by Porges(1985) in Mxedit software. To determine behavioral status, tools were developed by Scafidi et al(1990) were used. Collected data were analyzed with the SPSS program using paried t-test, ANOVA, and Pearson correlation. The result were as follow. 1. The results of the ANOVAs indicated that vagal tone were signifcantly lower during bathing than baseline and post-bathing. There were significant differences in heart period and heart rate levels across the bathing. But the mean oxygen saturations and respirations were no differences. Also, there were no significant differences on behavioral sign, motor activity, behavioral distress, weight changes, morbidity, and hospitalization period. 2. To evaluate the relation between vagal tone and subsequent parameters, the two groups (the high group had 19 subjects and low group had 21subjects) were divided by the mean baseline vagal tone. Vagal tone measured prior to bathing were significantly associated with respiration before bathing, vagal tone during bathing, and the magnitude of change in both vagal tone. But, other subsequent reactivities were no differences in two groups. 3. Correlations were also calculated between vagal tone and the subsequent physiological reactivities from baseline through after- bathing. Correlations were significant between baseline vagal tone and baseline heart rate, between baseline vagal tone and baseline heart period, between baseline vagal tone and oxygen saturation after bathing. In summary, the bathing in this study showed a stressful stimulus on premature infants through there was significance in the physiological parameters. In addition, our study represents the documentation that vagal tone reactivity in response to clearly defined external stimulation provides an index of infant's status.

• Clinical and Experimental Pediatrics
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• v.64 no.9
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• pp.480-488
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• 2021

Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study established the National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008) based on data from a nationwide population-based health screening program and data on healthcare utilization for children. Methods: The NICKs-2008 study consisted of the Korean National Health Insurance System (NHIS) and the National Health Screening Program for Infants and Children (NHSPIC) databases comprising children born in 2008 (n=469,248) and 2009 (n=448,459) in the Republic of Korea. The NHIS database contains data on age, sex, residential area, income, healthcare utilization (International Classification of Diseases10 codes, procedure codes, and drug classification codes), and healthcare providers. The NHSPIC consists of 7 screening rounds. These screening sessions comprised physical examination, developmental screening (rounds 2-7), a general health questionnaire, and age-specific anticipatory guidance. Results: During the 10-year follow-up, 2,718 children (0.3%) died, including more boys than girls (hazard ratio, 1.145; P<0.001). A total of 848,048 children participated in at least 1 of the 7 rounds of the NHSPIC, while 96,046 participated in all 7 screening programs. A total of 823 infants (0.1%) weighed less than 1,000 g, 3,177 (0.4%) weighed 1,000-1,499 g, 37,166 (4.4%) weighed 1,500-2,499 g, 773,081 (91.4%) weighed 2,500-4,000 g, and 32,016 (5.1%) weighed over 4,000 g. There were 23,404 premature babies (5.5%) in 2008 compared to 23,368 (5.6%) in 2009. The developmental screening test indicated appropriate development in 95%-98% of children, follow-up requirements for 1%-4% of children, and recommendations for further evaluation for 1% of children. Conclusion: The NICKs-2008, which integrates data from the NHIS and NHSPIC databases, can be used to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.145-153
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• 2001

Purpose : This study was conducted to describe the attitude of hospital staff toward the hospice program. The purpose of this study was to promote the extension and organization of hospice activities to include hospital staff. Method : This is a descriptive study using a survey method. The subjects for this study were the nurses, physicians, technicians, and support staff at Wonju Christian Hospital. Using a stratified sampling method based on position of staff, the researchers recruited 430 staff members as the sample for this study. Data collection was done through a questionnaire developed by the researchers. The data were analyzed using descriptive statistics and content analysis. Findings : 1)Ninety seven percent (n=417) of the subjects understood the concept of hospice care, and 97.4% (n=419) answered that dying patients should be respected. When considering the hospice team, the subjects of this study indicated that the team should include family members (n=245), physicians (n=77), pastors (n=41), and nurses (n=34), in that order of priority. 2) When asked to indicate priorities for systematic operation of a hospice program, the subjects indicated that the highest priority was "setting up a team for hospice service(31.4%)", followed by "setting up a hospice ward(28.6%)". Sixty seven percent(n=289) recognized the importance of the hospice activities provided by the volunteers, and 85.3%(n=367) intended to use the hospice service of the hospital. The highest merit of hospital-based hospice program is 'acomplishment of mission'. 3) The average score on attitude toward death was 2.84(maximum=4), and the best needful service except hospitalization is 'constructing of support system'. Conclusion : Most of the staff at Wonju Christian Hospital perceive the necessity for systematic hospice activities, and that to achieve this goal, administrative and structural support at the hospital governance level is the first necessity. The results of this study could be useful for any hospital which is in the first stages of setting up and promoting a hospice program.

• Journal of Digital Convergence
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• v.10 no.6
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• pp.311-319
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• 2012

This study, by grasping the degree of anxiety of Korean mothers and multicultural family mothers because of their hospitalized children, was aimed to arrange the basic data for developing the program to help the mothers of Korea and multicultural family reduce the anxiety happening due to the hospitalization of their children and adapt to their environment. Methods: The subjects of the study were a total of 200 people composed of 100 multicultural family mothers, and 100 Korean mothers respectively whose children were hospitalized in the pediatric department of K university hospital located in Daejeon City. And the period of data collection was from Aug 1, 2010 to Aug 31, 2010.As a study tool, the measuring tool of Kim Jeong Taek(1978), which STAI of Sielberger(1972) was adapted to Koreans, was used.The collected data was analyzed using SPSS WIN 12.0. Results. A result of the state anxiety of the Korean mothers with that of the multicultural family mothers of the inpatient children, Korean mothers 2.11, multicultural family mothers 2.17, result of temperament anxiety showed Korean mothers 2.09, multicultural family mothers 1.94. As a result of comparing the anxiety of the Korean mothers with that of the multicultural family mothers of the inpatient children, there was no difference between groups in both temperament anxiety and state anxiety. In a situation of anxiety, when there was no explanation of the treatment or therapy, both Korean mothers and multicultural family mothers showed the severe anxiety. In the degree of anxiety according to the general characteristics of the mothers of the inpatient children, there was not a statistically significant result in anxiety according to general characteristics of the inpatient children of korean family mothers, there was a significant difference in state anxiety according to the state of average monthly income in Korean mothers(P<.05), however, there was a significant one in temperament anxiety in the course of perceiving a test method in multicultural family mothers(P<.05). In the degree of anxiety according to the general characteristics of the mothers of the inpatient children, there was a significant difference in state anxiety according to the state of average monthly income in Korean mothers(P<.05), however, there was a significant one in temperament anxiety in the course of perceiving a test method in multicultural family mothers(P<.05). Conclusion: Through the results of the study above, no matter what socio-demographic characteristics of the mothers of the inpatient children are, regardless of the general characteristics of the inpatient children, it was found out that most of mothers felt anxiety.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.33-54
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• 1981

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

• 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.