• Title/Summary/Keyword: Nursing history

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Prediction Model for Reduced Bone mass in Women using Individual Characteristics & Life Style Factors (여성의 개인적 특성과 생활양식요인을 이용한 골량감소 예측모형)

  • Lee, Eun-Nam;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.83-109
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    • 1998
  • This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

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Factors Influencing Cognitive Impairment of the Seniors using Senior Center (경로당 이용 노인의 인지기능장애 영향요인)

  • Lee, Sun Young;Kim, Yunyoung
    • Journal of Digital Convergence
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    • v.15 no.3
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    • pp.393-403
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    • 2017
  • The purpose of this study was to investigate the degree of cognitive impairment for the elders taking part in activities at senior community center and to identify the multiple factors affecting the cognitive dysfunction of them. Data were collected for the 375 elders taking part in activities at senior community center at 4 different areas of dong, up, and myun of C-city from June 2016 to July 2016, and their general characteristics as well as health-related characteristics, depression, and cognitive dysfunction were investigated and analyzed. The results of this study showed that cognitive dysfunction was affected by the age, education, economic support, history of stroke, and exercise. The risk of cognitive dysfunction was 3.50 times higher in patients over 80 years old than patients below 74 years old(p=.002), and the lower the level of education showed the higher the risk of cognitive dysfunction(p=.036)(p<.001). In addition, the risk of cognitive dysfunction was low in the absence of a history of stroke(p=.033), and the risk of cognitive dysfunction increased by 1.84 times if they do not exercise(p=.044). Based on the present study, It is required to consider the risk factors for cognitive dysfunction efforts to prevent and manage cognitive impairment before the onset of cognitive dysfunction.

The Principles of Total Quality Management(TQM) and Its Implementation. (총체적 질관리(Total Quality Management)의 이론적 배경과 그 적용실태)

  • Kang, So-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.388-407
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    • 1995
  • This study is (a) to describe the history of Total Quality Management (TQM) generated in the industry, health care service, and nursing society ; (b) to define the concept, total quality management including the definition of quality ; (C) to explain the each principle of TQM theory developed by main theorists, E. Deming, J. Juran, and B. Crosby ; (d) to give the examples related to TQM implementation at the health care organization ; and (e) to mention the extent to which the health care organizations are able to evaluate their cultural organization toward TQM and have had the way to measure the effect of TQM implementation. TQM referred to Continuous Quality Improvement(CQI), Quality Improvement(QI), and Total Quality Improvement(TQI), was not recognized by experts in the United States industry, but by economists in Japan until the end of the 1970's. However, the United States' government led to introduce the principles of TQM to general industry as well as health care service area so that TQM became a main philosophy to manage the organizations in health care service. TQM is a structured, systematic process for creating organization-wide participation in planning and implementing continuous improvement in quality. E. Deming established the "Chain reaction in Quality" and the fourteen point of TQM. The Chain reaction in quality is to describe the relationship among the reduction of waste, rework, and delay, quality improvement, customer satisfaction, and productivity. There are fourteen points to explain the principles of TQM by E. Deming. Juran defined the "Quality Trilogy" to improve the level of quality in any organization. Quality Trilogy has three steps such as quality planning, quality control, and quality improvement for implementing the TQM projects. Crosby describes his TQM theory by establishing "Four Absolutes" and "Fourteen steps in TQM" implementation. Until now, most healthcare organizations have made efforts to organize the TQM task team and to implement TQM principles with various issues. There are three priorities to select the TQM issues : High-volume, High-risk, and Problem-prone. However, there is no absolute, credible measurement yet to evaluate the effects of TQM implementation in health care organization regardless of the classification of health care organizations, geographical background, and social influence. Thus, developing the evaluation way in terms of TQM is the foremost task in health service area. The most important thing for TQM implementation in the organization is to settle up the concept, cultural transformation from traditional management toward quality.

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A Study on Job Satisfaction Degree and Organizational Commitment of the Clinical Nurses (임상간호사의 직무만족정도와 조직몰입에 관한 연구)

  • Kim, Youn-Keun;Moon, Heui-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.457-474
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    • 1998
  • This study was aimed to be able to dedicate to the quality promotion of nursing of the nurses and the development of hospital organization by investigating interrelations between job satisfaction degree and organizational commitment of the clinical nurses. The objects of this study have been 507 nurses working in university hospital in Seoul and the materials have been collected through structured questionnaires for 14 days from Feb. 23. 1998 through March 8. The materials have been analyzed and computerized statistically with SPSS. General characteristics have been analyzed by practical number and percentage. and job satisfaction degree and organizational commitment have been analyzed by average evaluation marks and standard deviation and the relation between general characteristics and job satisfaction degree and the relation between general characteristics and organizational commitment have been analyzed by t-test or F-test(ANOVA) according to the characteristics of variable. Correlations between job satisfaction degree and organizational commitment have been analyzed by Pearson's Correlation Coefficient. The followings are the summaries of the results of the study: 1. The degree of job satisfaction of the object was 3.26 in average on the basic of 5 marks and worth area showed highest by 3.78 while wage and welfare 2.70 the lowest when analyzed 11 areas. 2. Organizational commitment of the object showed 3.24 in average on the basic of 5 marks. 3. According to the age. marital status. educational background. employment experience. experience in current department. position. types of work. department of work. wage, satisfaction about the current department, whether they wish to be transferred to the other department and whether they are transferred or not. there were significant differences in the characters of job satisfaction degree when general characteristics and job satisfaction degree have been examined. 4. According to the age. marital status. religion. educational background. employment history. position and experience in current department. types of work. department of work. wage. satisfaction about the department they are assigned. whether they wish to be transferred. Whether they are transferred or not and number of being transferred to the other department. there have been significant differences in the characters of organizational commitment when general characteristics and organizational commitment have been examined relatively. 5. Correlations between the degree of job satisfaction and organizational commitment has shown the degree of organizational commitment higher respectively when the degree of job satisfaction was higher. the degree of sanitation factor was higher and the degree of motive factor was higher (r=.73799. r=.6826. r=.6570). 6. The result of the analysis of correlations between organizational commitment and the turnover intension and job related action has shown comparatively high reverse correlations (r=.6375) between organizational commitment and turnover intension and low reverse correlations(r=.3253) between organizational commitment and job related action. Based on the above results. the study of the ways of increasing the degree of satisfaction about wage. welfare. position and stability and the supervision of the senior which showed the low degree of job satisfaction should be conducted and through the management of the degree of job satisfaction which affects to the organizational commitment, I would like to propose that the ways of increasing the sense of commitment to the hospital organization of the nurses should be studied.

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The factors to identify high risk family (고위험가족 선별을 위한 위험요인 분석)

  • 방숙명
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.351-361
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    • 1995
  • The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.

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The Development and Test of Self-Efficacy Promotion Program on Self-care of Hemodialysis Patients (혈액투석환자의 자가간호를 위한 자기효능증진 프로그램 개발 및 효과)

  • Song, Mi-Ryeong
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1066-1077
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    • 2000
  • The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by x$^2$ and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

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A Study on the Health Promoting Behavior of University Students (대학생의 건강증진행위에 대한 연구)

  • Yeoum, Soon-Gyo;Her, Eunn-Hee;Chung, Yeoun-Kang;Kown, Hye-Jin;Kim, Kyung-Hee;No, Eune-Sun;Han, Kyung-Soon;Han, Seung-Eui
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.396-409
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    • 1998
  • The purpose of this study is to inquire into the degree of health promotion activity of university students, and to confirm the general factors of health promotion behavior in order to offer basic data for a nursing strategy to improve health promotion behavior. For this research, data was collected from university men and women through questionnaires from February 18 to March 20 in 1998. The author develop a measuring instrument on the basis of related reviews of health promoting behavior in the prevention of chronic disease, as well as accounting for demographic factors, biological factors, and circumstanctial factors. The content validity of the instrument was authenticated by two professors of the science of nursing,. and the reliability was confirmed by a 'cronbach' ${\alpha}'$ after moditying the content through a pre-test on 30 students. 475 persons were analyzed in terms of an average, percentage, t-test, ANOVA by 'SPSS-PC'. The analyzed data was the following. 1. The acting degree of health promoting behavior was 3.26 point out of 6. Among the sub-levels of health promoting behavior, the order of importance was the following. self-actualization (4.62), interpersonal(4.60), stress management (4.0l), nutrition(3.68), responsibility(3.1l), liquid and cigaretles ues(2.85), and exercise (2.33). 2. The differences in health promoting behavior according to subject's general character were the following. Age(F=6.012, p=.003), major (F=7.243, P=.000), sex(t=7.60, P=.000), religion(F=2.454, p=.045), living status(F= 2.849, p=.024), health concern of parents(F= 7.596, P=.000), taking health programs(F= 2.710, p =.007), case history of the family( t = -1.980, p=.048). Health promoting behavior is affected by a higher age, majoring in the social sciences, having religion, male, living in the relatives' home, having to take health programs and a higher health concern of the parents. Suggestions: 1. The degree of health promoting behavior appears low in this study. It is crucial, therefore, to develop a health program to improve health promoting behavior and to study how to center the daily health life of students.

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Relationships among Body Image, Self-esteem and Health Promotion Behavior in Mastectomy Patients (유방절제술 환자의 신체상, 자아존중감과 건강증진행위의 관계)

  • Jeong, Kyeong-Sook;Park, Geum-Ja
    • Asian Oncology Nursing
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    • v.7 no.1
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    • pp.36-46
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    • 2007
  • Purpose: This study was designed to fine out the relationships among body image, self-esteem and health promotion behavior in mastectomy patients. Method: Data were obtained by self -reported questionnaires from 218 patients undergone mastectomy from September 1 to October 15, 2005. And data were analyzed using SPSS/PC WIN 12.0 program. For the statistical analysis of the date, frequency and percentage, mean and standard deviation, t-test, ANOVA and Scheffe test and Pearson's correlation coefficients were used. Result: The mean scores of the body image, self-esteem, and health promotion of the subjects were $41{\pm}7.40$ (range of scale : 17 to 68), $22.22{\pm}4.95$ range of scale : 10 to 40), and $130.45{\pm}23.99$ range of scale : 50 to 200), respectively. There were significant differences with the score of body image by the work type (F=4.018, p= .008), a number of child (F=3.069, p= .029), and participation with self help group program (t=68.177, p= .001). There were significant differences with the score of self-esteem by the type of religion (F=4.546, p= .002), work type (F=4.488, p= .004), post operation period (F=2.814, p= .026), and participation with self help group program (t=12.901, p= .001). There were significant differences with the score of the health promotion behavior by the type of religion (F=3.066, p= .018), economic state (F=11.765, p= .001), level of education (F=6.285, p= .001), operation site (F=.368, p=.027), family history (t=6.557, p= .011), and hope of breast reconstruction (t=7.025, p=.009). Relationship between body image and self-esteem showed moderate positive correlation (r=0.631, p= .001). The relationship between body image and health promotion behavior showed slightly positive correlation (r=0.257, p= .001). The relationship between self-esteem and health promotion behavior showed moderate positive correlation (r=0.431, p=.001). Conclusion: For the increasement of the health promotion behavior, it is needed to improve body image and self-esteem in mastectomy patients. And, It is needed to encourage to participate with self help group program in mastectomy patients.

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Descriptive Study on the Development of Educational Program for Mothers with Children who have had Open Heart Surgery in Congenital Heart Disease (개심술을 받은 심기형 환아모의 교육프로그램 개발을 위한 조사연구)

  • Lee, Kun-Ja;Jo, Hyun-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.73-83
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    • 2001
  • The aims of this study were to identify the mothers educational needs when they have children who have had open heart surgery in congenital heart disease, to identify the children's characteristics with this problem, and also to provide the basic information on the development of the educational program for the mothers. The subjects of the study were 101 mothers of children and their children hospitalized with congenital heart disease in pediatric wards of G. University Hospital in Inchon and S. Hospital in Puch on from June to November 2000. The study used a Likert-type questionnaire with 39 questions which was based on a previous questionnaire developed by Lee Mi-ryun(1989) for adult open heart surgery patients. The reliability of the questionnaire was Cronbach' ${\alpha}$=.9375. The data were collected directly from mothers of the patients in wards. The t-test, ANOVA was adopted for the data analysis. The key results of the study are as follows : 1) The average age of the children was 32.90 months. The majority of the children are male and weighted 3.0-3.5Kg at birth. Most of the children had VSD(29.7%), and 10.9% of children had a family history of heart disease. 2) An average score of 4.62 out of a maximum of 5.00 was recorded for the educational needs of the children's mother. The highest score of 4.69 was for home care after discharge followed by a score of 4.67 for diagnosis and prognosis on congenital heart disease. And pre-post operation care scored 4.51. The mean scores of single-question items of educational need were, in order, 4.81 for immunization after operation, 4.80 for recovery process, and 4.77 for prognosis of the disease. The score of 4.18 for measurement of intake and output was the lowest. 3) The analysis on the children's mothers educational needs by social-demographic characteristics such as sex, age of patient and mother, economical status, educational status, number of child, hospitalization times, and hospitalization cause showed no significant difference statistically, but there was a significant difference between mothers with jobs and with out jobs.

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A Study on Drinking, Smoking and Family Disease Histories in the Family Members of Cerebrovascular Disease Patients (뇌졸중 환자 가족의 음주, 흡연 및 가족병력에 관한 연구)

  • Choe, Myeon;Kim, Jong-Dai;Kim, Sung-Sil
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.6
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    • pp.1050-1054
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    • 1996
  • This project was to investigate cerebrovascular disease incidence relation to alcohol consumption, cigarette smoking and family disease history in the family members of normal and cerebrovascular disease patients, besides patients themselves. Alcohol consumption in the family members of cerebrovascular disease patients was significantly higher, especially in male with thirties, forties and fifties, than those of normal. Mean of daily cigarette smoking in the family members of cerebrovascular disease patients was found to be significantly higher, especially in males with forties and fifties, 1]lan those of normal families. Mean of monthly income of normal subjects was significantly higher than those of cerebrovasndar disease families(normal: $673, 000\pm$ 187, 000 won, cerebrovascular: $483, 000\pm213, 000$ won). A degree to be attacked with cerebrovascular disease was very higher in the family members of cerebrovascular disease patients than normal family. Such cases were much higher in father side than in mother side.

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