• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.117-131
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• 1998

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

• Journal of the Korean Society of Food Culture
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• v.18 no.1
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• pp.45-55
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• 2003

To investigate the relationship between dietary attitude and healthy status of office workers in Seoul was to be researched for 389 subjects (male: 224 and female: 165). As a result showed 69.4% of them moderately healthy state and 55.0% had a great interest in health. About 41.6% of the respondents was nonsmoker and 74.8% of them drunk alcohol once or twice a week. Only 28.0% of them responded to have breakfast three to four times a week. About 71.0% responded to skip breakfast'. The main reasons for it were 'the lack of time'(46.5%) and 'habitually'(22.6%). The usually preferred taste of food was showed to be 'hot' for 40.3%, the highest percentage. An attempt of supplemental food was 66.0%. The reason for it was shown to be 'for relaxation'(51.7%), followed by 'for prevention and treatment of diseases (23.1%). On dietary habit showed the groups of married and professional people won the hish scores on it. And the groups of those doing exercise once or twice a week, those having a sufficient sleep and those kept in a good food habit showed the high scores on it. The older age group showed the good dietary attitude regardless of occupation.

• Childhood Kidney Diseases
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• v.4 no.1
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• pp.69-76
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• 2000

Purpose: The Pathogenesis of primary noctllrnal enuresis(PNE) is still controversial. Genetic factor and maturational delay of micturition reflex including arousal disorder, lack of nocturnal Arginine Vasopressin(AVP) release and functional bladder capacity have been suggested. We analyzed the risk factors of PNE. Methods: Fifty five children with PNE (20 enuretics diagnosed at school physical examination of the first grade students at Mok-Dong Elementary School and 35 enuretics (Age 6-7 year) diagnosed at Ewha Womans University Mok Dong Hospital) and 221 control students without PNE at school physical examination were included. Genetic, stress and developmental factors, arousability, water intake, urine volume, maximun voiding volume and daytime voiding dysfunction were compared. Results: 1) There was no significant difference between PNE and control group in sex ratio, birth order, percentage of working mothers, parental and child personality, age to start walking, school record and duration of sleep. 2) Family history in the PNE group was significantly higher than control group ($20.0\%\;vs\;2.7\%$)(P<0.05). 3) The difficulty in arousal in the PNE group was significantly more common than the control group ($70.9\%\;vs\;54.3\%$)(P<0.05). 4) Nocturnal water intake in the PNE group was significantly greater than the control group ($330{\pm}158.2\;mL\;vs\;235{\pm}129.5\;mL$). Nocturnal urine volume in the PNE group was significantly greater than the control group ( $390{\pm}61.5\;mL\;vs\;140{\pm}43.2\;mL$)(P<0.05). Daily water intake and daily urine volume did not significantly differ between the two groups. 5) Maximum urine volume per void in the PNE group was significantly lower than the control group ($107{\pm}35.9\;mL\;vs\;236{\pm}41.3\;mL$). Daytime voiding dysfunction in the PNE group was significantly more common than the control group ($80.0\%\;vs\;57.9\%$). The voiding frequency in the PNE group was significantly greater than the control group ($7.0{\pm}3.6\;vs\;5.4{\pm}1.6$)(P<0.05). Conclusion: In addition to genetic factors and maturational delay of micturition reflex (difficulty in arousal, nocturnal polyuria and decreased functional bladder capacity) nocturnal polydypsia was found to be the important risk factors fur PNE. So nocturnal fluid restriction should be encouraged as the first-line management of PNE.

• Journal of Nutrition and Health
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• v.53 no.1
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• pp.13-26
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• 2020

Purpose: This study identified the relationship between dietary habits and health-related behaviors depending on the Big Five personality factors (extraversion, openness, agreeableness, conscientiousness, neuroticism). Methods: The NEO-II test was administered to 337 male and female college students in Seongnam City, Gyeonggi Province, and their dietary habits and health-related behaviors were surveyed. Results: The male participants showed higher scores for extraversion, openness, agreeableness, and conscientiousness compared to that of their female counterparts, while the female participants showed higher scores for neuroticism. As for the results of multivariate logistic regression analysis, in the case of men, higher scores for extraversion were related to a lower intake of instant/fast foods and a higher intake of vegetables; higher agreeableness scores were related to a lower intake of fruit; and higher neuroticism scores were related to a heavy intake of high-cholesterol foods. It was found that higher openness scores were associated with a higher intake of burnt fish/meat and a lower intake of animal fat, while higher agreeableness scores were related to a lower intake of burnt fish/meat in women. Also, those subjects with higher openness and agreeableness scores were found to better consider the nutritional balance when having a meal. In the case of the male participants, higher openness scores were related to increased physical activity, while higher neuroticism scores were related to increased smoking and a lack of sleep. As for the women, those with higher extraversion scores smoked more, while those who recorded higher agreeableness scores were involved in more physical activities. Conclusion: Differences were observed in dietary habits and health-related behaviors between men and women depending on personality factors, and the analysis results of some dietary habits according to personality factors were inconsistent with those of the overseas studies. Therefore, to provide customized nutritional counseling when considering each individual's personality factors, more research results from domestic samples should be collected and accumulated.