Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.
This study performed microbiological hazards analysis in raw food materials, cooking processes, kitchen staff, utensils, and the environment in order to obtain contamination levels of S. aureus in school foodservice operations. S. aureus was not detected in cooked foods offered by the foodservice operations; however, it was found in raw food materials prior to cooking. In the case of vegetables, S. aureus was detected in washed mung bean sprouts, parboiled mung bean sprouts, and bellflower roots both before and after disinfection, at levels of 2.2, 1.0, 1.0, and 1.0 log CFU/g, respectively. For processed foods, S. aureus was detected in one sample of packaged bean curd as well as in mung bean jelly cake at the level of 1.5 log CFU/g. For meat products, S. aureus was detected in beef brisket and chicken at levels of 2.3 and 1.3 log CFU/g, respectively. To determine microbiological hazard data for the hands and gloves of cooking personnel, the staff members were divided into two groups: a group presenting Enterobacteriaceae or coliforms, and another group presenting neither Enterobacteriaceae nor coliforms. The results showed that S. aureus was detected on the hands of staff in each group at levels of 2.0 and 2.1 log CFU/hand, respectively, and at 1.8 and 0.0 log CFU/hand on the gloves of staff in each group, respectively. Among kitchen utensils, as an environmental factor in school foodservice operations, S. aureus was detected on meat knives, mixing bowls, and dish cloths at levels exceeding 1.0 log CFU/hand.
Journal of agricultural medicine and community health
/
v.35
no.2
/
pp.111-123
/
2010
Objectives: The purpose of the present study is to examine the effects of the Field Management Training Program for home care services personnel on their understanding and professional competences. Methods: The subjects were 373 team managers of public home care services who participated in the training program. Data was collected with a self-administered questionnaire in April and September, 2007. The subjects' level of understanding of home care was measured by 35 questions divided into 8 categories while their professional competence was measured by 15 questions divided into 5 categories. Result: After attending the training, the subjects' understanding improved from 20.90 points (possible range: 4~32) to 26.11 points. The most improvement was evident in the Planning and Public Health Education categories. Their professional competences improved from 10.81 points (possible range: 4~16) to 12.51 points. The improvement of their understanding and professional competences differed across to training places. It was also evident that an increase in understanding brought about an increase in professional competence. Conclusion: The Field Management Training Program needs to be continued with efforts to reduce the differences of training effects between training places. And additional recommendations should be made through further evaluation of subsequent training programs.
To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.
Purpose: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find posssible factors influencing the onset and the course of the disorder. Method: We performed questionnaires in Kwangju on children from two primary schools from June,1 1998 to June 30 and carried out statistical analysis. Result: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02:1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor. The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as internal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. Conclusion: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.
It is the time of the Korean Wave booming throughout the world, placing Korean culture in the center of the world and its added value is unaccountable. At this prosperity, the preserving of the archetype of Korean dancing and digital contents making is becoming a task not only for the government but also for the private sector because culture industry has enormous added values. To achieve such goals, contents development is an urgent matter but establishing the value of the archetype of Korean traditional dancing must have priority. The public has to take an active role in rediscovering the values of traditional culture, and as the representative of Korean identity traditional dancing must be the object of a systematic art policy. This study will review the current status of 'digital contents program of the archetype of culture' for traditional dancing and will reconsider the modern value of preserving the archetype of culture to make a suggestion to the direction of culture art policies in the near future. The study acknowledged the lack of technical personnel majoring in the archetype of traditional dancing and the need of reviewing the credibility of historical research procedures. Even with the studies by industry-university collaboration and positioning of specialists, effective policies that will form the foundation for private firms to train personnels is in urgent need. In other words, training personnels, allocation of resource, securing funds, policies promoting collaboration between private and individual businesses, and the commercial recognition at private firms are still far from establishing. This is due to the fact that archetype of culture is not a business that creates revenue immediately, therefore the recognition of traditional dancing as an investable item by business-oriented firms or movements are difficult to find. To overcome such situation, software oriented policies that establish open communication and sharing with the public should be done at first rather than the quantity oriented hardware policies of contents development. Through this process the public can change the attitude on traditional dancing and traditional dancing could be newly recognized as a creative repository of culture and as public businesses giving birth to economic value.
The purpose of this study was to examine dental personnels' concern for health, their personal protection manner, and whether or not they were inoculated against hepatitis B and made an inquiry of patients about that. It's ultimately meant to serve as a basis for the preparation of an anti-infection guide for the protection of dental personnels against all sorts of infectious diseases. After a survey was conducted from March 29 through May 9, 2001, the following findings were obtained: (1) The dental personnel group that had worked for 5 to less than 7 years took health examination the most, with 71.4%, before joining the hospital, and 61.5% of those who had served for 9 years or more, the greatest percentage, took medical checkup after joining the hospital(P<0.05). (2) The largest percentage of being inoculated against the anti-B type hepatitis after employment was 71.4% of the dental personnels over 35, and 57.7% of those with 9-year or more working experiences. Therefore, their age and service term made a significant difference(P<0.05). (3) There was no significant gap in personal protection practices between the dental hygienists and nurse aids(P>0.05). But the use of safety goggles for treatment was not properly done, with just 1.48 on the basis of 3 points, whereas the use of mask was scored 2.40 and the use of gloves was scored 1.96. (4) After a narcotic was used once, the leftovers were wasted by 89.7% of the dental hygienists and 70.0% of the nurse aids. More dental hygienists wasted them(P<0.05). (5) For hand washing, antibiotic liquid soap was used by 19.3% of the dental hygienists and 10.0% of the nurse aids, which were both very low percentage. And just 37.2% of the dental hygienists utilized a disposable paper towel to dry their hands, and only 36.0% of the nurse aids used the same(P<0.05).
BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.
The purpose of this study was to examine the professionalism of dental hygienists in dental institutions and the influential factors for their professionalism in an attempt to seek ways of enhancing the professionalism of dental hygienists. The subjects in this study were 172 dental hygienists who worked in dental institutions in Busan and Gimhae. A self-administered survey was conducted to gather data, and an experimental analysis was carried out to analyze the collected data. The major findings of the study were as follows: First, concerning professionalism, self-regulation belief(3.70) ranked highest(3.42), followed by service belief(3.65), autonomy belief(3.31), a sense of vocational calling(3.30) and utilization of the professional organization as a standard(3.12). Second, the professionalism of the dental hygienists was significantly better when their title was higher, when they were older, when they got a larger monthly pay and when they intended to work for a longer time. Third, as for the influential factors for their professionalism, age, marital status, the estimated term of working at the workplace and opinion on reemployment were also identified as the significant variables that were up to the standard level of significance(p=0.05). The findings of the study suggest that in order to boost the professionalism of dental hygienists, it's required to take institutional measures to give them more responsibility, autonomy and authority, and how to improve personnel administration by providing strong motivation for them to look at their workplaces more favorably and keep on working for a long time should discreetly be considered.
The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.
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