• Journal of Korean Academy of Nursing
• /
• v.34 no.7
• /
• pp.1277-1287
• /
• 2004

Purpose: This study was to evaluate the effects of a short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus patients. Method: A nonequivalent control group with a pre post test was designed. Data collection was done from October 2003 to June, 2004 at a hospital. Glycemic metabolism was measured by a.c., p.c. and $HbA_{1}c$, and lipid metabolism was measured by cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Body Composition was measured by body weight, body mass index, waist, measurement waist per hip ratio, body fat, muscle weight and abdominal fat tissue(intra abdominal distance). The Experimental group, which was composed of 29 participants, was educated based on a life style modification protocol at a weekly meeting for 12 weeks and carried out exercise, diet along individual parameters and self monitoring, while 24 participants in the control group received only diet education. Result: 1. The experimental group showed a significant lower a.c.(t=2.11, p=.04) and $HbA_{1}c$(t=2.65, p=.01) compared to those of the control group. 2. The experimental group showed a significant lower LDL than the results of the control group(t=2.42, p=.02). 3. The experimental group showed a significant lower weight(t=3.09, p=.00), BMI(t=3.01, p=.00), body fat(t=2.94, p=.01) and abdominal fat tissue(t=3.05, p=.01) than those of the control group. Conclusion: The results provided evidence for the effectiveness of a short term comprehensive life style modification program composed of exercise, diet, support, self efficacy elevation and self monitoring in type 2 diabetes mellitus.

• Journal of Korean Academy of Nursing Administration
• /
• v.5 no.2
• /
• pp.355-368
• /
• 1999

This study was a quasi-experimental study to investigate the effect of a telephone follow-up on the self-care and the satisfaction on nursing care in G-I surgical patients. The subjects of the study were 38 patients, 19 in experimental group and 19 in control group, who discharged after gastrointestinal surgery at a university hospital in Taegu between August 11. 1998 and October 16, 1998. The telephone follow-up program for the experiment was developed by the researcher, which contained consultation, support and encouragement for self-care after discharge. Number of the instruments used for measurement of the outcome variables were 5, self-care after discharge, satisfaction(1)${\sim}$(2) on Nursing care. intention to visit the hospital again. intention to recommend the hospital to others. The results of this study were as follows ; 1. The first hypothesis, "The subjects of experimental group will show a higher level of self-care than the subjects of control group" was rejected (F=.48. p=.4937). 2. The Second hypothesis. "The subjects of experimental group will show a higher level of satisfaction than the subjects of control group" was accepted partly as follows. 1) The hypothesis 2-1, "The subjects of experimental group will show a higher level of satisfaction(1) than the subjects of control group" was accepted(F=4.04. p=.0496). 2) The hypothesis 2-2. "The subjects of experimental group will show a higher level of satisfaction(2) than the subjects of control group" was accepted(F=8.48. p=.0064). 3) The hypothesis 2-3, "The subjects of experimental group will show a higher level of intention to visit hospital again than the subjects of control group" was rejected(F=1.95. p=.1723). 4) The hypothesis 2-4. "The subjects of experimental group will show a higher level of intention to recommend the hospital to others than the subjects of control group" was rejected(F=1.43. p=.2411) . From the results of this study, the telephone follow-up can be regarded as an effective nursing intervention for the discharged patients.

• Journal of Korean Academy of Nursing
• /
• v.30 no.5
• /
• pp.1195-1206
• /
• 2000

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

• Journal of Digital Convergence
• /
• v.13 no.8
• /
• pp.345-356
• /
• 2015

Health service quality is increasingly emphasized, and primary care service is no exception in this. This study identified patients' perception of quality considering convergence factors associated with increased utilization among patients over the age of 65 using community health centers. A total of 307 respondents were included in the analysis. The results showed that positive perceptions on facility and environment, patient-centered care, technical knowledge and skills of physicians, and emotional support with nurses and non-medical workers were statistically and significantly associated with higher utilization. In order to increase utilization of primary care service at community health centers, they need to manage and improve these factors.

• Journal of Digital Convergence
• /
• v.10 no.3
• /
• pp.241-250
• /
• 2012

Low birth rate is a persisting national challenge that causes a decrease in productive population and an increase in encumbrances by ever rising insurance premiums, eventually threatening the existence of the country. This study investigated the effectiveness of the current government's undergoing economic support of the child-birth promotion policy, "go-un-mam card", and suggested improvement plans about the problems derived on the basis of the perceptions of the card users. Multi-response analysis was used to find out the preference of the policy, and chi-square test was conducted to discover the user satisfaction rate and intent of re-parturition. Also, descriptive analysis was performed to identify the degree of the policy recognition. The results illustrated that a significant association exists between the satisfaction rate and the intention of re-parturition. In addition, pregnant women gained information about the policy from governmental agencies and medical institution as well as by word of mouth; then, applied to the policy. Also, the card users only took an advantage of discounts in the hospitals within the supported monetary amounts. Moreover, the card users expressed their dissatisfaction at the monetary amounts. For instance, the users were dissatisfied with the limit on the amount to be used in a day and requested upgrade on the monetary amounts. Based on the result, the government will improve and develop the go-un-mam card for the ultimate purpose of policy, increasing birth-rate.

• Journal of the Institute of Electronics Engineers of Korea TC
• /
• v.48 no.2
• /
• pp.29-35
• /
• 2011

PHR(Personal Health Record) to support the lifelong healthcare of their medical information to consumers anytime, anywhere can view and manage health information to help direct input can be defined as a service. The PHR is to provide services efficiently and PHR systems and health-related information systems should be integrated and linked. However, the current healthcare information systems field in order to meet the growing demand for healthcare construction and operation of various systems, and accordingly continues to increase budget for information, but the current system, although the association between a variety of system integration and linkage is being made. This paper proposes a Integrated information system on Healthcare based on Web service to solve problems mentioned above. SOA(Service Oriented Architecture) is a major method of integrating services on the Web. It enables new requirements to be added to existing systems without modification of legacy services, so it makes rapid adaption to varying business environment. Therefore, In this paper, PHR services based on SOA as a platform for the health care sector to design and implement an integrated information system by web services based PHR services for the construction of a new integrated information system is proving to be a suitable model.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.139-145
• /
• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.12
• /
• pp.8176-8186
• /
• 2015

This research was conducted for the purpose of developing a high-fidelity simulation education program, applying it to clinical field and analyzing this program's effect on nursing college students in order to solve problems being caused from the gap between the adult nursing theoretical class and practical education. As the analysis method, this study developed a scenario including an algorithm for caring hyperkalemia patients, the evaluation check list, and debriefing according to the adult nursing theoretical class's learning goal and measured the high-fidelity simulation program's effect in using the non-equivalent control group pre-test and post-test design. As the results from the analysis, there secured the simulation education program's general properties and dependent variable's homogeneity in the experimental group and the control group. The nursing simulation practice program for hyperkalemia patients showed slight effect on the experimental group compared to the control group in fields such as nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. (t=-83.313, p<.001, t=-3.169, p=.003, t=-2.473, p=.017, t=-4.036, p<.001, t=-5.044, p<.001). High-Fidelity simulation programs in conjunction with an adult nursing theory classes of nursing students nursing practice ability, problem solving ability, critical thinking skills, self-confidence of nursing, and knowledge. This simulation program may be an effective educational method for nursing practice and also support improved quality of nursing education.

• Journal of Korean Academy of Nursing
• /
• v.29 no.5
• /
• pp.1087-1102
• /
• 1999

Diabetes mellitus, a universal and prevalent chronic disease, is projected to be one of the most formidable worldwide health problems in the 21st century. For those living with diabetes, there is a need for self-care skills to manage a complex medical regimen. Self-efficacy which refers to one's belief in his/her capability to monitor and perform the daily activities required to manage diabetes has be found to be related to self-care. The concept of self-efficacy comes from social cognitive theory which maintains that cognitive mechanism mediate the performance of behavior. The literature cites several research studies which show a strong relationship between self-efficacy and self-care behavior. Meta-analysis is a technique that enables systematic review and quantitative integration of the results from multiple primary studies that are relevant to a particular research question. Therefore, this study was done using meta-analysis to quantitatively integrate the results of independent research studies to obtain numerical estimates of the overall effect of a self-efficacy with diabetic patient on self-care behaviors. The research proceeded in three stages : 1) literature search and retrieval of studies in which self-efficacy was related to self-care, 2) coding, and 3) calculation of mean effect size and data analysis. Seventeen studies which met the research criteria included study population of adults with diabetes, measures of self-care and measures of self-efficacy as a predictive variable. Computation of effect size was done on DSTAT which is a statistical computer program specifically designed for meta-analysis. To determine the effect of self-efficacy on self-care practice homogeneity tests were conducted. Pooled effect size estimates, to determine the best subvariable for composite variables, metabolic control variables and component of self-efficacy and self-care, indicated that the effect of self-efficacy composite on self-care composite was moderate to large. The weighted mean effect size of self-efficacy composite and self-care composite were ＋.76 and the confidence interval was from ＋.66 to ＋.86 with the number of subjects being 1,545. The total for this meta-analysis result showed that the weighted mean effect sizes ranged from ＋.70 to ＋1.81 which indicates a large effect. But since reliabilities of the instruments in the primary studies were low or not stated, caution must be applied in unconditionally accepting the results from these effect sizes. Meta-analysis is a useful took for clarifying the status of knowledge development and guiding decision making about future research and this study confirmed that there is a relationship between self-efficacy and self-care in patients with diabetes. It, thus, provides support for nurses to promote self-efficacy in their patients. While most of the studies included in this meta-analysis used social cognitive theory as a framework for the study, some studies use Fishbein & Ajzen's attitude model as a model for active self-care. Future research is needed to more fully define the concept of self-care and to determine what it is that makes patients feel competent in their self-care activities. The results of this study showed that self-efficacy can promote self-care. Future research is needed with experimental design to determine nursing interventions that will increase self-efficacy.

• Journal of Korean Academy of Nursing
• /
• v.3 no.1
• /
• pp.85-95
• /
• 1972

For the purpose to clarify the effects of nursing, intervention with comfort measures which promote rest, exercise and sleep on the patient′s rehabilitation, this study was carried out on 119 postoperative patients at St. Mary′s Hospital, the National Medical Center and Seoul Red Cross Hospital during the 9 months period from March 1971 to November 1971. In this study one experimental nursing approach was utilized; an emphasis on interpersonal techniques along with physical care-comfort measures. A daily evening care including support and instruction was given to facilitate interaction of nursing to the experimental group by the investigator. For the control group, routine hospital nursing care was performed. The nursing observation was followed for 4 days postoperatively and recorded in check list. The results of the findings were as follows. 1. 3.5% of control group and 32.3% of experimental group got out of bed within 24 hours postoperatively. 38.6% of control group got out of bed within 72 hours postoperatively where only 16.1% of the experimental group did (x$^2$= 19.865, p<0.005). Interaction in nursing is, in turn, significantly more effective than the usual routine care in improving rate of healing. 2. The irritations and tension that may interfere patient′s sleep and rest at night can be reduced to a minimum if nursing environment is better controlled with planned nursing care for individual patient. Various treatments which tend to give patient discomfort may preferably be performed before 6 p.m. if not absolutely indicated. 3. During 4 days of observation the patients without administration of sedatives and analgesics postoperatively were 25.9% in the experimental group where as 10.5% in the control group. The frequency of administration of sedatives and analgesics in average was 1.4 in the experimental group, and 2.0 in the control group. This indicates that not all postoperative discomforts expressed by the patients should be regarded as incision pain, and those discomforts could be relieved to a certain extent by nursing interventions effectively. 4. There were significant differences between the responses to nursing care given in the experimental group and 33% of the control group in average through 4 days of observation responded "good". 3.6% of the experimental group and 17. 1% of the control group responded "poor" in this study. It was recommended that the study be replicated in a more defined and controlled manner. Some alternative areas for investigation were suggested.