• Title/Summary/Keyword: Preventive management

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Factors Related to Psychosocial Stress and Fatigue Symptom Among Nurses Working at Ward and Operating Room in University Hospitals (대학병원 병동 및 수술실 근무 간호사의 사회심리적 스트레스와 피로수준에 관련된 요인)

  • Park, An-Sook;Son, Mi-Kyung;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1781-1791
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    • 2013
  • The present study was intended to measure the level of psychosocial stress and fatigue symptom according to the various characteristics such as sociodemographic, health-related, job-related, job stress factors, and psychosocial factors among nurses working at ward and operating room in university hospitals, and to reveal the relation between these factors and psychosocial stress and fatigue symptom. The self-administered questionnaires were given to 220 nurses working at ward, and 147 nurses working at operating room in 4 participating hospitals located in Daejeon City during the period from July 1st to Aug 31st, 2012. As a results, the factors related to the psychosocial stress of nurses working at ward were age, subjective health status, job career, satisfaction of work, fit to the job, job demand, job control, coworker support, self-esteem, locus of control, type A behavior pattern. In operating room, there were age, sleep hours, subjective health status, job career, physical burden of work, satisfaction of work, fit to the job, consider quitting the job, job demand, job control, type A behavior pattern. The factors related to the fatigue symptoms of nurses working at ward were age, leisure time, subjective health status, satisfaction of work, consider quitting the job, job demand, locus of control, type A behavior pattern. In operating room, there were age, subjective health status, physical burden of work, supervisor support, coworker support, locus of control. Based on the study results, we suggest that the factors related to psychosocial stress and fatigue symptom of nurses were different from working station. We need development and application of programs to keep under management psychosocial stress and fatigue symptom.

Management of Tuberculosis Outbreak in a Small Military Unit Following the Korean National Guideline (국내 결핵관리지침에 따른 군내 결핵 집단발병 관리 사례 보고)

  • Ji, Sang Hoon;Kim, Hee Jin;Choi, Chang Min
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.5-10
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    • 2007
  • Background: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. Material and Methods: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. Results: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). Conclusion: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.

Results of Postoperative Radiation Therapy of Rectal Cancers - with the Emphasis of the Overall Treatment Time - (직장암의 수술 후 방사선치료의 성적 - 예후 인자와 전체 치료기간이 미치는 영향에 관한 고찰 -)

  • Kim Joo-Young;Lee Myung-Hag;Lee Kyu-Chan
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.303-310
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    • 1998
  • Purpose : To evaluate the results of the treatment of locally advanced but resectable rectal cancers and to analyze prognostic factors. especially with the emphasis on the treatment time factor. Materials and Methods : There were 71 patients with rectal cancer who had been treated by curative surgical procedure and postoperative radiotherapy from August 1989 to December 1993. The minimum follow up period was 24 months and the median follow-up was 35 months Radiation therapy had been given by 6 MV linear accelerator by parallel opposing or four-box portals. Whole pelvis was treated up to 5040 cGy in most cases. Systemic chemotherapy had been given in 94$\%$ of the patients, mostly with 5-FU/ACNU regimen. Assessment for the overall and disease-free survival rates were done by life-table method and prognostic factors by Log-Rank tests. Results : Five-year overall survival, disease-free survival were 58.8$\%$ and 57$\%$, respectively. Two-year local control rate was 76.6$\%$. Stage according to Modified Astler-Coller (MAC) system, over 4 positive lymph nodes, over 6weeks interval between definitive surgery and adjuvant radiotherapy and over 7 days of interruption during radiotherapy period were statistically significant, or borderline significant prognostic factors. Conclusion : The treatment results of patients with rectal cancers are comparable to those of other large institutes. The treatment results for the patients with bowel wall penetration and/or positive regional lymph nodes were still discouraging for their high local recurrence rate for the patients with MAC 'c' stage diseases and high distant metastases rate even for the patients with node-negative diseases. Maybe more effective regimen of chemotherapy would be needed with proper route and schedule. To maximize postoperative adjuvant treatment. radiotherapy should be started at least within 6 weeks after surgery and preferably as soon as wound healing is completed. Interruption of treatment during radiotherapy course affects disease-free survival badly, especially if exceeds 7 days. So, the total treatment period trout definitive surgery to the completion of radiotherapy should be kept as minimal as possiable.

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Life Style and Eating Behavior of Stroke Patients in Daegu and Gyeongbuk Province, Korea (대구.경북지역 뇌졸중 환자의 생활습관 및 식행동 특성)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.319-332
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    • 2009
  • The present study was performed to analyze the life style and eating behavior of stroke patients and to find the risk factors related to stroke incidence in Daegu and Gyeongbuk Province, Korea. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community inhabitants who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews using questionnaires on the general characteristics, life-style, eating behavior, food intake frequency and food preference. The high body mass index, preexisting diseases such as diabetes and hypertension, stroke family history, smoking, overeating habit and high preference for sweet, greasy and meat foods appeared to be the risk factors for stroke incidence. On the other hand, the results suggest that life style of regular exercise and nonsmoking, food habits of green tea drinking and enough chewing, preference for Korean meal type, high intake frequency for legumes, vegetables, mushrooms, seaweeds, fishes and shell fishes, soy milk and green tea might be the protective factors for the stroke. Therefore, maintenance of healthy weight, the prevention and management of the deteriorative chronic diseases, change of life style and improvement of eating behaviors are considered to be important for stroke prevention.

Can 3-year Disease-free Survival be Substituted for 5-year Overall Survival in Curatively Resected Gastric Cancer? (치유 절제술을 받은 위암 환자에서의 3년 무병생존이 5년 전체생존을 대치할 수 있는가?)

  • Kwon, Sung-Joon;Kim, Hyoung-Ju;Kim, Mi-Kyung
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.174-179
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    • 2005
  • Purpose: The 5-year survival rate is the most useful parameter for evaluating the effect of management on most malignant tumors. Recurrence after a curative resection for gastric cancer occurs mostly within 3 years of the operation, which caused us to evaluate whether a 3-year disease-free survival (3DFS) can be substituted for a 5-year overall survival (5OS). Materials and Methods: We reviewed the medical records of 656 consecutive patients who had undergone a curative resection for gastric cancer To assess whether 3DFS represents 5OS, we used a simple linear regression with survival probability calculated by using the survival function. Results: Recurrence was found in 175 cases during the follow-up periods. The accumulative frequencies of recurrence at postoperative 1 year, 3 years, and 5 years were 46% (81 cases), 89% (156 cases), and 97% (170 cases), respectively. The correlation coefficient (r) and the coefficient of determination $(r^2)$ between 3DFS and 5OS were 0.87 and 0.76, respectively, and the regression equation was $5OS=0.18+(0.80{\times}3DFS)$. The r and $R^2$ according to the type of recurrence were 0.89 and 0.80 in peritoneal seeding, 0.88 and 0.78 in hematogeneous metastasis, and 0.86 and 0.73 in local recurrence, respectively. The r (0.77) and $r^2$ (0.60) were relatively lower in low stages (stage I and II) compared to r (0.88) and $r^2(0.77)$ in high stages (stage III and IV). Conclusion: The 3DFS is an excellent predictor of 5OS. Therefore, if we use the former as the treatment evaluating method, 2-year time reduction in assessing and reporting treatment results is expected.

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Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)

  • Woo, Seon-Hye
    • Journal of Home Health Care Nursing
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    • v.11 no.1
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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Development of Internet Information Push-Delivery System Design of Smoking Cessation for Health Promotion (지역주민의 건강증진을 위한 인터넷 금연 강화 프로그램 개발)

  • Kim, Young-Bok;Shin, Jun-Ho;Kim, Shin-Woel
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.287-301
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    • 2004
  • Objectives: The development of internet programs for smoking cessation was motivated to quit smoking in the large group of smokers. This personalized program consisted of tailored message to consider the smokers characteristics, and contain the informations on the outcomes of smoking cessation and the skills to be used in the quit attempts. The purpose of this study was to develop the internet management program and information push-delivery system for smoking cessation to encourage the personal intention to quit smoking. Methods: We conducted in 3 steps as developing push service to encourage intention of smoking cessation, analyzing problems of smoking cessation program through the pilot test and suggesting improvements by implication stages. Results: This program is delivered for 30 days. if the participants do not fail to quit smoking. The contents consisted of 13 stages which were divided on starting period. practical period, maintenance period and success period. And push service afforded the tailored message to participants using their e-mail. According to the evaluation of pilot test, the problems of internet information push-delivery service for smoking cessation were the over-tasks per visiting time, recording style of participants, difficulty of terms and sentences, lack of visual effects, absence of follow-up module and unsuitable link with main homepage. Improvements were divided on 3 stages by implication period. The first stage included the immediate improvements as improving link with homepage, modifying menu of smoking information and upload file of notice part. The second stage included the short term improvements as alleviating condition of withdrawal, coordinating start stage of retrial, modifying errors of information push-delivery service and addition of educational materials. The third stage included the long term improvements as development of follow-up module, cost-effectiveness evaluation, reducing contents quantity, introduction of checking style, compensation of graphics effect and review for SMS utilization. Conclusions: This program contribute to improving smoking cessation rate. Therefore this program should be tested in a community to evaluate the effectiveness. To promote the effectiveness, this program should be developed the contents and the strategies for various targets, and established the follow-up system for ex-smokers.

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Blood Pressure of Healthy Newborns in the First Week of Life (분당 차병원에서 출생한 신생아 혈압치 비교)

  • Lee Jung-Sun;Park Shin-I;Park Hye-Won;Kim Se-Hyun;Hah Tae-Sun;Lee Jun-Ho
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.8-14
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    • 2005
  • Purpose : This study was peformed to study normative blood pressure data in full-term neonates that may be used to facilitate Identification of neonatal hypertension.Methods : 383 newborns born in our hospital from May 2003 to January 2004 were enrolled in this study Using an oscillometric device(BP-88 NEXT, COLIN Corp.), their blood pressures were measured more than one time within a week after birth. According to each clinical variable such as sex, delivery mode, birth weight, gestational age and presence of maternal disease or perinatal problems, we divided the population into groups and calculated the mean blood pressures of each group. We compared mean blood pressures between the divided groups according to each clinical variable statistically.Results : Mean systolic and diastolic blood pressure of the Population was 70.8$\pm$ 10.9 mmHg and 43.4 $\pm$ 8.0 mmHg, respectively. There was no satistically significant difference in blood pressure according to clinical variables. Mean systolic pressure showed positive correlation with birth weight and gestational age(r=0.1420, 0.03130).Conclusion : Our results are almost in agreement with Zubrow's data from 695 newborns in U.S.A, 1995. Our data may be helpful for early detection and management of neonatal hypertension, thereby maintaining renal function ,and preventing possible complications of renal disease.

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Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Evaluation of Microbial Contamination in the Manufacturing Process of Non-Heated Frozen Rice Cakes (비가열 냉동떡의 제조공정에 대한 미생물 오염도 평가)

  • Yong-Sik, Yoon;Eun-In, Yang;Young-Soo, Kim
    • Journal of Food Hygiene and Safety
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    • v.37 no.6
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    • pp.400-410
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    • 2022
  • This study was performed to analyze the microbial contamination levels of three non-heated rice cake manufacturers in terms of seasonal manufacturing process and to investigate the effects of summertime soaking on contamination levels and temperature-controlled soaking in water on reduction in microbial levels. The total aerobic bacteria (TAB) ranged from 2.69 log CFU/g to 5.08 log CFU/g in the produce, but the microbial contamination increased sharply during soaking. The levels of TAB and coliforms during summer soaking were 7.01 and 3.96 log CFU/g, respectively, and this was significantly higher than those in other seasons. The contamination level was high in the subsequent freezing, with the TAB level (6.24 log CFU/g) exceeding the legal standard. The temperature of soaking water in summer increased from 19.1℃ to 26.8℃ after 12 h of soaking. The microbial contamination was significantly high commensurate with increased soaking time, and the TAB level in the frozen process exceeded the legal standard from 9 h of soaking. The use of ice packs to prevent the increase in temperature of the soaking water in summer resulted in maintenance of temperature at 20.1℃ for up to 12 h. The average TAB value in the freezing process was 4.42 log CFU/g after 12 h of soaking, and this is 1.77 log CFU/g lower than that before. Based on these results, it was determined that controlling the soaking time and water temperature are essential for the production of a safe unheated frozen rice cake. The safety of the HACCP system could be established by applying these preventive management standards.