• Child Health Nursing Research
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• 제21권1호
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• pp.37-45
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• 2015

목적 본 연구는 미숙아로 태어난 유아와 정상아로 태어난 유아의 건강 관련 삶의 질을 비교하고, 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 요인을 파악하여, 이들의 유아기 건강 관련 삶의 질 향상에 기여하기 위하여 시도되었다. 방법 연구 방법은 자가보고식 설문지를 이용하였으며, 연구 대상자는 인터넷 카페에서 미숙아로 출생한 유아의 부모 80명과 정상아 부모 83명이었다. 연구 도구는 TNO-AZL에서 개발한 TAPQOL를 사용하였고, 수집된 자료는 SPSS 20.0을 사용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, 다중회귀분석을 이용하였다. 결과 미숙아로 태어난 유아의 삶의 질 점수는 100점 만점에 80.6점(${\pm}9.9$)이었으며, 정상아로 태어난 유아의 삶의 질 점수는 85.0점(${\pm}8.3$)으로, 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 4.4점(${\pm}1.4$) 낮았다. 미숙아 집단이 정상아 집단에 비해 삶의 질 점수가 낮은 영역으로는 운동기능, 불안, 긍정적 기분, 활기참 및 의사소통 등이었다. 두 집단간 삶의 질 점수 차이가 가장 큰 영역은 운동기능과 의사소통이었다. 미숙아로 태어난 유아의 건강 관련 삶의 질에 영향을 미치는 변수는 '신생아실 입원기간(7일 이상)'과 '출생체중(1,000 g 미만)'으로 나타났으며, 두 변수의 설명력은 17%였다. 즉, 신생아실 입원기간이 7일 미만이고, 출생 시 체중이 1,000 g 이상인 아동이 그렇지 않은 아동보다 건강 관련 삶의 질 점수가 높았다. 결론 미숙아로 태어난 아동의 건강 관련 삶의 질은 이들의 출생 시 체중 및 신생아실 입원기간 등이 영향을 미치므로 미숙아 추후 프로그램을 개발할 때 출생체중, 재태기간 및 신생아집중치료실 입원기간 등으로 고려해야 할 것이다.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 임상간호연구
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• 제17권1호
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• pp.113-122
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• 2011

Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.

• 보건행정학회지
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• 제25권4호
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• pp.256-263
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• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• 대한간호학회지
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• 제25권4호
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• pp.825-836
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• 1995

This ethnogrphic exploratory study sought to de-fine the meaning of Sanhubyung, as consequence from the perspective of the women who experienced it. A convenience sample of 9 elderly women in San Francisco. and 20 postpartal women and their 20 non-professional helpers during postpartum in Seoul, Korea were observed and interviewed for 23 months from January 1991 to December 1992 at the Human Development Center in San Francisco and at the hospital and their homes in Seoul, Korea. Sanhubyung was regarded as the consequence of "Doing a Sanhujori Wrongly," as a group of symptoms or sequelae which have two types of characteristics of symptoms . chronic and acute. It can be called a culture bound syndrome in the cultural context re-lated to childbearing phenomenon in Korea. If women violate the principles of Sanhujori, such symptoms can appear at various times : during the period of postpartum itself, at any time, periodically, especially at the anniversary of the child's birth, late forties, and in old age. Acute symptoms that can be classified into immediate and late types include painful and edematous gingiva, sensitive teeth, strange sensation and pain in the knees or backache. Besides, there is a localized sense of soreness and pain ; sense of being in a draft and cold, stomach upset, GI irritation, chilling, shivering, and tiredness, pain and dazzling in the eyes. Chronic symptoms occur in the head, neck, teeth, back, hands, knees, hands and feet, arms and legs, eyes, sinews and joints, bones, and in the body or as a whole. Generally these symptoms are pain, often accompanying a feeling of being cold and in a draft, regardless of actual weather conditions. In conclusion, this findings reflect the Oriental way of thought of causal relationship of women's health and illness based on the wholistic paradigm of harmony and balance of two forces, Yin(cold) -Yang(hot). It provides a challenge to the professional sector to rethink the effect of culture on health and illness. Finally, it suggests care providers use cultural assessment for the appropriateness of the intervention and quality of care for desirable health outcomes.

• 보건교육건강증진학회지
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• 제22권4호
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• pp.91-105
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• 2005

Purpose: The purpose of this study was to describe the current status of managing educational programs for tobacco use prevention at middle and high schools located in Busan. Methods: Using a survey method with a 29-item self-administration questionnaire, the data were collected from January 10 through February 18, 2005, from school nurses as well as teachers major in healthcare of 227 participant schools. Results: A strategic plan for school-based educational programs of tobacco use prevention was mainly developed by a school nurse at middle school and a teacher in charge of school discipline at high school. The educational programs for tobacco use prevention were implemented for approximately 40% of schools in Busan with the budget ranged from 110,000 won to 200,000 won a year. Eighty five percepts of the schools had anti-tobacco regulations and guidelines in place. Twenty two percents of the middle and high schools collected the data regarding adolescents' smoking status periodically. Over 70% of schools provided tobacco use prevention education programs as a part of regular semester curriculum. Conclusions: For making the management of educational programs for tobacco use prevention effective and consistent with government's anti-smoking policy, schools need (a) development of tobacco management guideline and regulations with participation of teachers, students, and parents, (b) clear job and role descriptions for personnel to plan and implement anti-tobacco programs, (c) compilation of the budget enough to implement the programs, (d) periodically assessment of adolescents' smoking status, and evaluation of the programs to monitor whether those are effective for adolescents' health promotion; and (e) to make an effort to less range of quality in educational programs for tobacco use.

• 근관절건강학회지
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• 제10권2호
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• pp.188-202
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• 2003

The aim of study was to investigate the effects of 12 forms of Sun-style Tai-Chi for arthritis(TCA) on physical symptom(pain, tenderness, swelling fatigue, and blood pressure), physical function(balance, flexibility, grip strength) and social-psychological health status in osteoarthritis(OA) patients and rheumatoid arthritis(RA) patients. This study was done with one group pretest-posttest design. A total 21 arthritis patients(6 OA patient and 15 RA patient) participated in 60 minute session consisting of warm-up exercise 12-main movement including qigong, and cool-down exercise twice a week for 6weeks. Physiological and social-psychological variables were measured before and after TCA 12 form. The researcher who completed a Tai Chi workshop for exercise leaders in Australia and Seoul taught the Tai Chi movement step by step until the patient felt comfort enough to perform them correctly by themselves during the first 4 weeks. At the last 2 weeks, the subject perform 10-15set of these at a session with traditional music to help patients move in a slow tempo. TCA 12 forms program showed significant improvement in fatigue(p=0.039) of rheumatoid arthritis patient and pain(p=0.006), fatigue(p=0.013), tenderness(p=0.032), flexibility(rt arm up, p=0.014, If arm up, P=0.003), grip strength(rt hand, p=0.002, If hand, P=0.003) of osteoarthritis patients. With assessment by Arthritis Impact Measurement Scale 2 questionnaire(AIMS2), physical component(0.002) and social interaction(0.025) on osteoarthritis patients were significantly improved. Evaluation of the participants about TCA exercise noted that the exercise was fairly easy(23.6%), moderately difficult(57.1%), and fairly difficult(14.3%). Considering the result of this study, TCA exercise program was more effective in pain, tenderness, grip strength, flexibility, and physical and social interaction on osteoarthritis patients than rheumatoid arthritis patients. Tai-Chi for arthritis 12 form was an appropriate intensity exercise for osteoarthritis patients.

• 부모자녀건강학회지
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• 제10권2호
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• pp.147-157
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• 2007

Purpose: Assessment of stress and coping effort of hospitalized children's mother are very important factor to support and recover the children. The purpose of this study was to identify the stress and coping effort in mothers whose children are hospitalized. And analyzes the correlation between mother's stress and coping effort on the hospitalized children. Method: This study surveyed 70 mothers whose children are hospitalized. The data was collected for this study at one university hospital in Daejeon from June 1,2007 to July 10, 2007. The instruments used in this study were the mother's stress scale which was developed by Ok-Nam, You(1998), modified by Ho-Jin, Mun(2001), and the mother's coping effort were measured with the Coping Health Inventory for Parents(CHIP) developed by McCubbin and Patterson(1981). The data was analyzed by using SPSS program and include ANOVA, and Pearson's Correlation. Result: The mother's stress was average 2.42 out of a possible 4 points. Type of coping effort was in order of type III(cope with it by understanding medical circumstances)(M=2.73), type I(Cope with it through positive definition)(M=2.43), type II (cope with it by maintaining psychological stability)(M=2.28). Total coping effort according to general character of mothers whose children are hospitalized showed a significant difference in occupation(P<.05). Correlations between mother's stress and total coping effort was r=-.361(P<.05). Conclusion: This study based on nursing of stress and coping effort of hospitalized children's mothers. Pediatric nurses need to establish a stronger communication board and a relationship between medical staff and children's parents so that have supportive information. And to establish a support program that strengthens the coping effort of hospitalized children's mothers.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2609-2619
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• 2015

본 연구는 노인요양시설 노인들의 우울과 건강상태, 일상생활수행능력, 수면상태의 관련성을 파악하고자 실시하였다. 연구대상자는 노인요양시설에서 거주하는 만 65세 이상의 노인을 대상으로 하였다. 노인요양시설 노인들의 우울 관련성은 시력상태, 치아상태, 수면의 질, 수면상태 등과 관련이 있었으며, 시력상태가 나쁜 군, 치아상태가 나쁜 군, 수면의 질이 나쁜 군, 수면장애가 있는 군에서 높게 나타났다. 우울과의 상관관계에서는 우울과 연령과는 음의 상관관계로 나타났고, 치아상태, 수면의 질 등이 양의 상관관계가 있는 것으로 나타났다. 노인요양시설 노인들의 우울에 영향을 미치는 요인으로 시력상태, 치아상태, 수면상태, 청력상태 등이 관련성이 높게 나타났다. 결론적으로, 노인요양시설 노인들의 우울과의 관련성은 개인이 인지하는 건강상태와 관련이 높으며, 건강관리와 간호중재도 개인별 건강상태에 세심한 관심과 시력상태, 치아상태가 낮은 노인관리가 중요하다고 하겠다.

• International Journal of Advanced Culture Technology
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• 제7권2호
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.