• Title/Summary/Keyword: Nursing Care Environment

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A Study of the Relationship on the Perceived Family Support and the Level of Depression among Adolescents (청소년이 지각한 가족지지와 우울과의 상관관계 연구)

  • Park Myung Hee;Kim Chang Sook;Suh Young Sook;Suh Hee Sook;No Hyun Shin
    • Journal of Korean Public Health Nursing
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    • v.12 no.2
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    • pp.67-88
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    • 1998
  • Present study was attempt to explore the relationship between perceived family support and depression and to emphasize the importance or needs of family support in psychological care especially among adolescents. Study subjects comprized of 308 high school students including vocational students in part, and data collection was done in the Kwangju City area in April. 1998. The Moos Family Environment Scale and the Zung's Self-Rating Depression Scale modified by investigators were used as measurement tools of 59 item questionnaire and in data analysis, statistical methods of T-test, ANOVA. and Pearson Correlation Coefficient were utilized. The study findings are as follows 1. The hypothesis of the study, 'the higher the degree of perceived family support among adolescents, the lower the level of depression', was supported (r=-0.4469, p<.001). 2. Some variables in demographic characteristics related to the degree of family support with statistical significance were school division of vacational vs non-vocational(t=-2.02, p<.05), age(f=5.47, p<.01), family monthly income (f=2.49, p<.05), mother's level of education (f=3.01. p<.05), residence at developmental stage (f=2.87, p<.05), personal problem of highest priority at present(f=7.73, p<.001), and family problem perceived by adolescents(f=7.38, p< .001). 3. Items In general characteristics related to the level of depression with statistical significance were sex(t=-2.91, p<.0l). mother's level of education(f=2.53. p<.05). residence at developmental stage (f=3.95. p<.0l). present personal problem of highest priority (f=3.68. p<.1l). and perceived in-family problem (f=4.58. p<.001). 4. The mean score of the degree of perceived family support was 61.26 $(SD=\pm14.45)$ in a range of 21.00 to 96.00 ; that of the level of depression. 43.74 $(SD=\pm8.04)$ in a range of 23.00 to 67.00. which demonstrated that the higher the degree of perceived family support, the lower the level of depression. In conclusion. it was found that the degree of family support perceived by adolescents is a variable affecting the level of depression. Based on the study outcome, further research suggestions can be made as such that repeated studies are needed in order to delineate the various factors affecting family support and depression, and a study involving family support implementation program is required as a nursing intervention for the development of emotional security among adolescents, perceived family support, depression, adolescence.

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Developing Measurement Items for the Service Quality of Clinical Trials based on the Brady & Cronin Model (Brady & Cronin의 모델에 기반한 임상시험 서비스 질 측정 문항 개발)

  • Go-Eun Lee;Sanghee Kim;Sue Kim;Sang Hui Chu;Jeong-Ho Seok;So Yoon Kim
    • The Journal of KAIRB
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    • v.6 no.1
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    • pp.17-31
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    • 2024
  • Purpose: This study aims to develop preliminary items for measuring the perceived service quality of clinical trials among participants and to verify content validity. Methods: This study was designed as a methodological study. A conceptual framework was established based on Brady and Cronin's hierarchical model, and preliminary items were prepared through translation-back-translation, a review of existing instruments, and in-depth interviews with clinical trial participants and clinical research coordinators. The final items were completed through content validity testing by experts and a review of items by clinical trial participants for the prepared preliminary items. Results: Through this study, a set of 58 items across four domains (quality of interaction with researchers, the physical environment, performance procedures, and performance results) and 9 components (information·education·communication, trust, respect for participant preferences, securing facilities and space, accessibility, comfortability, informed consent, coordination of care, subjective understanding of clinical trials) on the service quality of clinical trials were completed. The scale content validity index of all preliminary items was 0.96, meeting the recommended standards. The individual-item content validity index also meets the recommended criteria for most items, excluding four items. Conclusion: This study holds significance in developing items to measure the quality of clinical trial execution from the perspective of participants. By verifying the reliability and validity of these items through subsequent research, it is expected that they can be utilized as a valuable instrument to devise strategies for improving the quality of clinical trials.

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A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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Confirmatory Analysis of Perception and Preference Scales for Work Characteristics among Korean Nurses (중환자실 근무환경 특성에 대한 간호사의 인지도와 선호도 도구 검증)

  • ;;Barbara Daily
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.215-224
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    • 1999
  • The study was conducted to centum the construct of individual perception and preference for work characteristics as personal factors influencing Korean nurses' job satisfaction. The subjects of the study were 231 nurses who are currently working in intensive care units and have been for a minimum of 6 months. The study used the Staff Perception and Preference Scale(Song et al., 1997) to measure the individual's perception and preference on the technical. practice. and management components of the ideal work environment. The Korean version of the Staff Perception and Preference Scale consists of 16 items on perception and 13 on preference with each item related on a scale from 1(not at all) to 4(a great deal). Psychometric testing revealed that the preference and perception scale is internally consistent with Chronbach's alphas of .83 for perception scale arid .80 for preference scale. The subscales of the perception and preference scale also showed acceptable reliability for the early stage of the development of the instruments with Chronbach alphas of .62-.76 and .69-.83 respectively. Criterion-related validity of the scale was tested by examining correlations with individual growth need that is conceptually close to individual preference. but not to individual perception. Individual growth need was significantly related to individual preference(r=.63, p<.05), but the correlation with the perception scale was not significant. A separate factor analysis for the each of perception and preference scales was performed with a three-factor loading solution based on a previous study. The results on the staff perception scale confirmed with varimax rotation that the items were cleanly and strongly loaded on technique. practice and management components, which together explained 50.7% of the variance. The factor analysis on the staff preference scale also yielded a three factor solution that explained 56.7% of the variance. but items on technique and management components were loaded together. This phenomena may due to the current nursing delivery system in Korea where nurses never experience either shared governance nor case management, and as a results they may not be able to consider management roles as their potential extended roles. Therefore, more efforts should be given to enhance nurses' autonomy and decision making in the technique, practice and management components of their work environment. Meanwhile, there is a need for continuously confirming and developing tools for individual perception and preferences to effectively enhance job satisfaction among Korean nurses through innovative work environments.

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Study on Elements influencing on Job Satisfaction of Employees in Hospice and Palliative Care Organization (호스피스.완화의료기관 종사자의 직무만족도에 영향을 미치는 요인에 관한 연구)

  • Lee, Myoung-Hee;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.7 no.1
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    • pp.15-28
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    • 2007
  • This study was focused on figure out what kinds of elements are influencing on job satisfaction with approach of the educational system. It was also to figure out how work characteristics and role conflicts of employees influence on job satisfaction. Objects of study were employeeswho had been working in Hospice and Palliative medical center at least for 6 months, and they were doctors, nurses, ministers, and welfare workers. Collected materials were analyzed by Frequency Analysis, One-way ANOVA, Correlation Analysis, and SimpleRegression Analysis. Results from study can be summarized like below. The first, job satisfaction of workers in Hospice and Palliative medical center were 3.36, and this numerical value is pretty high over all. For saying from the higher to the lower satisfaction level, there were satisfaction with job itself, satisfaction with co-workers, satisfaction with seniors (superiors), and satisfaction with organizations, on the other hands, satisfaction with salaries was turned out as the lowest level among those. The second, role conflict was 2.63, and it is considered as the medium level. after inquiring into it by elements of role conflict, they felt many environmental difficulties compared to other workers in different fields such as environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc. The third, work environment influencing on job satisfaction are as follows. Professional environment among characteristics of work environment was significant statistically. Job satisfaction of ministers was the highest; others were in the order of doctors, welfare workers, and nurses. For employment history, job satisfaction was higher as they have more and longer job experience including whole professional experience both in hospice and palliative medical center. In addition, participating in hospice and palliative programs, intensive training regularly was significantly. Job Motivation was also significant statistically. Especially, job satisfaction was higher when people decided to work in hospice and palliative medical center because of individual desire (self-realization). Lastly, influence of role conflict on job satisfaction is as follows. Environmental difficulty, role ambiguity, insufficient ability, process obscurity, etc showed the significant meaning statistically, and the lower role conflict was related with the higher job satisfaction. Suggestions for next study based on such results are as follows in order to improve or increase job satisfaction of employees in hospice/palliative medical centers. The first, to expand education opportunity of employees is needed to increase job satisfactionof hospice/palliatives medical centers. Participating in intensive programs and seminars by types of occupation and acquiring professional knowledge are very important since employees are motivated by those activities. For that, developing and activating intensive education/programs by professional occupations are suggested. The second, dividing roles of employees and determining each job's limit clearly in hospice/palliative medical centers are required. For that, study developing standard job regulations is suggested for each professional job. Lastly, developing and providing reasonable salaries is needed because low salaries of hospice/palliative medical centers are the absolute reason lowering job satisfaction. Therefore, this paper suggests improving the salary level of employees of hospice/palliative medical centers and developing practical plan for it.

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A Comparative Analysis of the Level of Occupational Health : Before and After the Subsidiary Program on Health Care Management of Small Scale Industries (영세사업장 보건관리 지원사업 실시 전후의 산업보건수준 비교 분석)

  • Jung, Hye Sun
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.58-83
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    • 1995
  • The small scale industries which have less than 30 employees occupy 86.5% of total number of industries in Korea. And though they have higher accident rate and lower environmental condition than big industries, it has been not mandatory to appointing health care manager at factory. So, from 1993, government subsidizes to the health care management of small industries. The purpose of this study is to identify the real feature of health care status in small industries, and to evaluate the level of health care management, before and after the subsidiary program. 65 small plating industries which have been managed by the same health care management support institution in 1993 were selected for study. Of the 65 industries, 3 which have not taken both environmental evaluation and health screening in 1994, and 9 which have closed were excluded from study sample. And the remaining 53 were analyzed by using the results of environmental evaluation and health screening, reported to the Ministry of Labor, before and after the subsidiary program, the analysis was done by the comparison of the two year paired data of the same industry. Over-permissible-limit rate, health screening implementation rate, above grade C rate were calculated and compared. The status of health care management ; 1. Of the sample industries, 96.9% provide protective equipment and 80.0% set up ventilating system. Protective gloves (89.2%) and protective clothing (80.0%) are widely provided, but ear plugs (4.6%) are rarely provided. 21.5% of the protective equipment are well put on, and 40.4% of the ventilating systems function well. 2. In 1993, 35 industries, 53.8% of the sample, checked working environment twice. Over-permissible-limit rates of heavy metal (12.2%), suspended particle (11.1%), noise (5.5%) were high. To put on protective equipment and to set up local ventilating system were pointed out by the examiners. 3. General health screening was done at 63.1% of the sample industries and 35.3% of total workers were examined. Specific health screening was done at 93.8% of the sample industries and 75.4% of workers were examined. 15.5% of workers was provided to be above grade C and to have digestive system disease (43.3%), circulatory disease (18.9%), and hematopoietic disease (14.2%), etc. 4. In 1993, the subsidiary program of health care management was provided in forms of health education, health counseling, and rounding check of working field. And 61.5%, 83.0%, 55.4% of sample industries respectively received it. The average visit per industry was 1.8. Comparisons of the level of occupational health before and after the subsidiary program ; 1. Over-permissible-limit rates of hazardous factors of 1993 and that of 1994 were compared. The rates of suspended particle, noise, organic solvent of 1994 (37.5%, 13.4%, 24.2% respectively) were higher than that of 1993 (25.0%, 6.0%, 6.3% respectively). In the case of acid, there was no difference between the rate of 1993 and that of 1994. Only the rate of heavy metal decreased from 12.9% in 1993 to 3.0% in 1994. 2. General health screening was done at 38.7% of the sample industries in 1993 and at 44.6% in 1994. But the implementation rate of specific health screening decreased from 72.4% in 1993 to 64.6% in 1994. 3. The implementation rate of specific health screening was analyzed by some health factors. The rate of suspended particle increased from 61.8% in 1993 to 91.2% in 1994. But the rates of the others-noise, organic solvent, heavy metal, specific chemical substances-decreased. 4. Above grade C rate in health screening increased from 27.8% in 1993 to 35.5% in 1994. But that of endocrine disorders and pulmonary disease decreased.

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Philosophic Investigation of the 'Ghi(氣)' Phenomena ('기(氣)' 현상에 대한 철학적 고찰)

  • Lee, Hyun-Ju
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.50-67
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    • 1998
  • When recognition of the Ghi(氣) which exist in all things, is changed on the aspects of the science of nursing, the view of health and nursing will be more efficient and can be developed as the proper concept for Korean culture. I think it is nessary to confirm which philosophical basis of the will be applicable to nursing and how to it has to be developed. Therefore I can for the research of the Ghi phenomena to attain the Thoughts of philosophy that is appropriate to expound those phenomena. And I attempt to induct "the fusion of horizons" to unify the view of the I world between Korea and the West. The Ghi is very energetic and omnipresent among the universe, Nature, and the human being. So it can organize all the primary elements of mental and I physical function of human as like life, mind, breath, feeling, energy, etc. A general concept of the Ghi is described as follows ; (1) The Ghi is the origin and essence to organize the universe, Nature, and the human being. (2) It is the perpetually movable thing. (3) And there are continuous transmission between the Ghi of the universe and the human through 'body, mind, and soul. For review on the philosophic basis of the Ghi, I studied out the identity of the doctrine of Li and Ch'i(理氣論) in the field of philosophy of Korea and the West. In Korea, the concept of the Vigor is based on Ch'i monolism(기일원론) and Li Ch'i dualism (이기이원론) of Yul-gok Lee's, Toi-kye Lee's, Hwa-dam's, and/or Hekang's. These are indispensable for the view of the world of Korea as Metaphysical ideology, Concrete science, Materialism, Ontology, and Epistemology. From the viewpoint of the philosophy of the West, the doctrine of Li and Ch'i(이기론) of Korea is identical with the doctrine of Li and Ch'i(이기론) of Joo-ja, Idea of Plato, Metaphysics of Aristotle, World Spirit(Weltgeist) of Hegel, and Existentialism of Heidegger. In the nursing theory of the West, some of them referred to the Ghi as like Energy field theory of Rogers and Energy exchange of Neuman. Though there are different in terminology, "energy" and the "Ghi" are induced comparable therapeutic action between the human and the environments. With the nursing theory of Korea, I have made an attempt to compare the Ghi with metaparadigm of nursing-the human being, the environment, the health, and the nursing. For the most part, the alternative therapy is resonable to the frame of the nursing theory of Korea. It is easy to apply alternative therapy on the every spot of nursing. So this therapy could be a kind of forms as nursing therapy in the nursing centers where take the duties of supporting in local societies. In result, independent nursing intervention will be activated by the nurse who puts up with the major parts. It is available to apply this therapy to palliation of pain, insomnia of infant, Sanhujori (산후조리), pain of menstruation, arthritis. And the alternative therapy makes it possible to propose the nursing model which represent originality, tradition, and history of the nursing of Korea. Additionally, in the field of the nursing, it is indispensable to choose a suitable methodology which is considered whether it is matched with a theory of philosophy in the boundary and object of the research. Because there are many way to get the knowledge of nursing related to the Ghi. In the science of nursing, context of sociocultural background and frame are required to understand the person who need to take care of (nursing client). But the value systems of the West and the East are distinctive each other as well as the behavior of health persuance. Therefore it is the basic research data of great worth to review philosophical the Ghi phenomena which is well known to Korean.

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Comparative Study on the Job Satisfaction of Part-time Nurses and Internship Nurses (시간제 간호사 및 인턴간호사의 직무만족도에 관한 비교연구)

  • Choi, Sook-Ja
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.93-105
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    • 1999
  • Recently, Korean health care industry managers are paying more attention to customer oriented service, the rationalization of business administration, and quality control of service to adjust their business to outer environment since IMF bailout program. They are focusing on the cost reduction through remodeling the size and structure of man power, viz. labor flexibility. Nurses are not free from this juncture and contingent nurses are increasing fast. This article intends to verify the actual condition of two types of contingent nurses -part-time nurses and internship nurses-and to compare their job satisfaction to provide basic resource for efficient management of nurse man power. The concrete goals of this article are; Firstly, to verify the actual condition of their employment. Secondly, to compare their job satisfaction. And Thirdly, to the relation between employment condition and job satisfaction. To accomplish these research goals, a statistical survey was executed, in which 384 questionnaires - 66 for manager nurses, 318 for contingent nurses-were given to nurses working at 66 general hospitals-which have at least 100 beds-in Seoul. Among them, 121 questionnaires-of 28 general hospitals-were returned. Then, the data coded and submitted to mean, standard deviation, T-test, variance analysis (ANOVA), correlation analysis, multiple regression analysis with SAS program. The research results of the contingent nurses are followings: 1. Two types of contingent nurses shows similar age spans: they are mostly 21 - 30 years old and unmarried. But internship nurses have high level of educational career. Part - time nurses spread at general beds, out -patient part, intensive care part, operation part, etc, but internship nurses work mostly at general beds. 2. Two groups shows difference in actual employment condition: average employment career of part -time nurses is 7.0 months but internship nurses' is 2.0 months: average duty-on days per month of part - time nurses are 23.7 days but internship nurses' are 24.8 days. But there are little difference in average working time per day: 7.7 hours for part -time nurses and 0 hours for internship nurses. 3. The average wage per month for part -time nurses is 836,026 won but for internship nurses is 557,428 won-66.7% of part-time nurses'. Both groups are enjoying little additional pay. 4. Both groups are getting job not so much through advertisement of newspaper or hospitals as through acquainted person or college. 5. Both groups show very high level of job satisfaction: 3.2195 for part -time nurses and 3.2881 for internship nurses. But they show very low satisfaction on payment level compared with other categories and two groups show meaningful difference(P<.0001). 6. The multiple regression test reveals the factors related with job satisfaction: wage level, working part(OR or ICU), age, job career, and motive of contingent job-taking('because I can take care of family duties at the same time') influence positively: motive of contingent job-taking('because I can work regularly without alternation') influences negatively.

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CQI Activities for the Reduction of Clostridium difficile Associated Diarrhea in NCU of a University Hospital (일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동)

  • Park, Eun Suk;Chang, Kyung Hee;Youn, Young Ok;Lee, Jung Sin;Kim, Tae Gon;Yea, Han Seung;Kim, Sun Ho;Shin, Jeong Won;Lee, Kyungwon;Kim, June Myung
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.10-21
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    • 2001
  • Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

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Family Support and Hopelessness in Patients Admitted to Neuro-Surgical Intensive Care Unit (중환자가 지각한 가족지지와 절망감과의 관계연구)

  • 김현실;조미영
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.620-635
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    • 1992
  • This study identified correlations between perceived family support and hopelessness in patients admitted to Neuro - surgical Intensive Care Units. The purpose was to enhance theoretical understanding of the relationships of these two variables. The subjects of this study were 51 patients admitted to N-lCU, at three general hospitals in Seoul. Data were collected by researcher in structured interviews from Aug. 12 to Oct. 13, 1992. The research tools were parts of the Moos Family Environment Scale and the Beck Hopelessness Scale. The general characteristic data were analyzed for frequency and percentage ; the hypothesis was tested by the pearson product Moment Correlation Coefficient. After normality tests by using Kolmogorov - Sminorvtest, and T- test, ANOVA and Mann-Whitney U test, Kruskal -Wallis test were used on the Family Support and the Hopelessness about general charcteristics. The results of the above analysis were as follows 1) The average family support score for the group was 63.61 (tool average 51) and item average was 3.74 (tool item average 3) : the family support score of this sample was higher than average. The average family cohesion score of family support was 35.25 (tool average 27) and item average was 3.91 (tool item average 3). The average family expression score of family support was 28.35 (tool average 24) and item average was 3.57 (tool average 3). In this sample, perceived family expression was lower than family cohesion. 2) The average hopelessness score was 45.88 (tool average 60) and item average was 2.29 (tool item average 3) : the hopelessness score of this sample was low in comparison to the average. 3) The hypothesis in this study was supported. The main hypothesis that the higher the perceived family support level, the lower the level Of the hopelessness, was Supported (r=-.3869 p=.003). The sub-hypothesis that the higher the perceived family cohesion level, the lower the level of hopelessness, was supported(r=-.3688 p=.004). The sub-hypothesis that the higher the perceived family expression level, the lower the level of hopelessness, was supported (r=-.3068 p=.014). 4) General characteristics of the objects related to family support were ‘economic status’(p=.025) and ‘helping person’(P=.044) : the higher the economic status, the greater the family support. When the patient identified the helping person as a spouse, family support was rated more highly. The only general characteristic related to family cohesion was ‘helping person’(p=.041). No general characteristics were related to family expression. 5) The one general characteristic related to hopelessness was ‘education’(p=.002) : the higher their education, the lower their hopelessness. For these ICU patients, were related perceived family support and hopelessness, and family expression level was low in comparison to family cohesion level. The perceived family support of these seriously ill patients in situational crisis may have influenced the patient's emotional reaction of hopelessness. This study concluded that nurses in the ICU confirm the family support of the patient, and involve the family as the most intimate support systems in the care of the patient to help reduce the patient's hopelessness.

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