• 대한간호학회지
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• 제35권4호
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• pp.745-753
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• 2005

Purpose. The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. Methods. One-group, time series, quasi-experimental design with a pre-test and two post- tests was used. Data were collected from cognitively impaired home residents (N = 32) and nursing staff (N = 36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. Results. Incidence of aggressive behavior was high with a mean score of 3.09 (SD = 3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F = 2.925, p = .066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.00l). Conclusion. Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.

• 대한간호학회지
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• 제3권3호
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• pp.15-26
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• 1973

(Directed by Professor Hong, Shin Yong) Today, over seventy five Percent of the schools of nursing in Korea Provide a psychiatric experience in the basic curriculum. The psychiatric presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planning for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Milder Elizabeth Fletcher, was administered to fifty-three nursing students from three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar. 19, 1973 to May 19, 1973. The questionnaire of 100 statements was administered in the following way: (1) Part 1, Preconceptions. was. given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ , Expectations, Part Ⅱ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V , Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again. during the fourth week at the termination of the affiliation. Responses to Parts B, B, n, and f, wire written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of land an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students., The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results. of the study were as follows: 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r=573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The Part.1, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward tile psychiatric affiliation which affect their psychiatric nursing experience, 4. The Part Ⅰ, Expectations, data indicated inappropriate expectations of students related to lack of experience, Lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part Ⅴ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of fear and frustration due to the psychotic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further researches indicated in the following areas: 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.

• 대한간호학회지
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• 제3권3호
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• pp.62-72
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• 1973

THE author conducted a field survey form Feb.1, 1973 to March 31, 1973 in the Busan area, standing six "institutions" where mentally ill patients are kept. These six institutions are registered at Busan Government, but are not regular hospitals. There suits of these investigation are as follows: \circled1 There are six institutions. which are registered at Busan City Government. All six are operated by layman who have little psychiatric knowledge and little human is tic motivation. \circled2 These institutions are allegedly to promote the welfare of the mentally sick. However they give little help for the patients. And they do not even have a resident medical person. The staff of those places will not accept professional medical help, and try to keep all information secret. \circled3 The finances are largely composed of patients′fees and partially from city′s help. The buildings are of high quality compared with the poor therapeutic situation. There also exist factors which make the patients worse, i,e. very small room space, compelling the patients to sit in a uteral position. This situation makes them worse and more autistic. \circled4 At the time of this survey, those lucrative overcrowded six institutions had 1.000 patients. At the same time the legitimate hospitals in Busan area had about 200 patients, \circled5 In my opinion, the City Government must take a more positive policy for the mentally ill patients, instead of the passive attitude which has held till now. And most of all, these patients must be medically and humanistically helped, instead of being left in a forgotten, depressed snake pit.

• 한국조경학회지
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• 제35권3호
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• pp.50-61
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• 2007

The purpose of this study is to establish design guidelines for waterscape facilities of healing gardens in psychiatric hospitals. Data were collected through simulation and interview. The subjects included schizophrenic (n=42) and alcoholic (n=41) inpatients as well as medical staff personnel (n=40) at Maeumsarang Hospital. The results of this study are as follows: It was revealed that for all three groups the first preference was a natural flowing waterscape, and the second preference was a natural descending waterscape. The schizophrenic subjects had a greater preference for a static artificial waterscape and a descending artificial multistory waterscape than the other two groups. The alcoholic subjects preferred an ascending natural multistory waterscape. The analysis on the preference towards an ascending type and a descending type from the perspective of naturalness and complexity. Complexity had a greater influence than naturalness in the ascending waterscapes, and naturalness had more influence than complexity in the descending style waterscapes. Therefore, these factors need to be taken into consideration when designing either ascending or descending waterscape facilities. In general, the subjects preferred natural, dynamic and descending waterscapes to the artificial, static and ascending variety.

• 한국병원경영학회지
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• 제17권1호
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• pp.23-42
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• 2012

The purpose of this study is to identify the inpatient service quality at mental hospitals and to examine the effect of service quality on patient's overall satisfaction and customer loyalty. Data collection was done through conducting a survey of inpatients in three mental hospitals located in Chungnam, Korea using self administered questionnaire. The questionnaire included the modified version of 'service satisfaction scale for psychiatric patients' invented by Chul Kwon Kim and other members, which consists of five dimension of service quality: staff attitude, treatment quality, ward environment, access/cost and ward rule. Total 236 questionnaires were gathered and 219 were used for analysis. The data was analyzed by using version SAS9.2 and path analysis model was applied to test our hypothesis. As a result, the four factors of service (staff attitude, treatment quality, ward environment and ward rule) were extracted, which counted for 62.89% of the common variance. Moreover, Cronbach Alpha showed relatively high internal consistency of answer, all exceeding 0.6. According to the study, ward environment and treatment quality turned out to have direct influence on the patient's satisfaction. In addition, staff attitude and overall satisfaction directly influenced the customer loyalty while ward environment and ward rule indirectly had influence using overall satisfaction as a medium. In conclusion, in order to enhance the satisfaction and customer loyalty in mental hospitals, efforts in improving environmental service quality in particular is highly demanded.

• 대한간호학회지
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• 제24권1호
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• pp.47-57
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• 1994

The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

• Safety and Health at Work
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• 제7권1호
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• pp.32-37
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• 2016

Background: Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration. Methods: A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control. Results: A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/25.2 nmol/L, respectively. Conclusion: The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting aids is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff's personal alarm jackets so they are always in place and ready to be used.

• 보건의료산업학회지
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• 제11권1호
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• pp.27-42
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• 2017

Objectives : This study analyzes the characteristics of hospital organization structures, insurance claims reviews and assessment tasks and their effects on hospitals in Pusan. Methods : The data for this study were collected through interview and self-administered surveys in 109 hospitals. The study included only - hospitals with a minimum of 50beds and excluded those providing only dental, psychiatric, or long-term care. Results : The findings of this study state that the number of beds has an influence on the organizitional structure. Conclusions : Hospital managements should seek human resources management(the insurance claims reviewer and evaluator) schemes that take into account the characteristics of the medical institution. In addition, insurance claims review and assessment tasks in hospitals require considerable knowledge and experience, and hospitals should be equipped with staff that have the relevant expertise. Therefore, to further deepen knowledge, comprehensive training should be continuously carried out in order to produce specialists in claims review and assessment.

• 생물정신의학
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• 제11권1호
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• pp.61-63
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• 2004

We describe the case of a 73 year-old female patient, YSG, who initially presented with a manic episode without any previous psychiatric history and was later diagnosed as having a meningioma in the left frontal lobe. YSG's symptoms were characterized by hyperactivity, insomnia, aggressive behavior with an auditory hallucination. She showed no abnormal signs on a complete neurologic examination. A gadolinium-enhanced MRI study showed a huge, extra-axial mass with homogenous enhancement in the left high convexity of the frontal lobe. Her manic symptoms subsided after administration of risperidone 1mg and valproic acid 500mg daily, for three weeks without surgical resection of the tumor. These findings suggest that YSG's mania might have resulted from the left-sided frontal tumor, and that her symptoms were treated rapidly by small doses of risperidone combined with valproic acid. Medical staff who care for manic patients should be aware of this possibility of a organic lesion without evidence of neurologic disease.

• 중환자간호학회지
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• 제8권2호
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• pp.13-22
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• 2015

Purpose: This study identified the current status and perception of intensive care unit nurses' handover. Methods: A cross sectional descriptive survey was employed. The population included nurse managers and staff nurses who worked in intensive care units in hospitals with more than 500 beds and excluded nursing homes, psychiatric hospitals, and military hospitals. Results: Of the nurses, 61.7% were satisfied with the current handover method, 68.36% had no handover-related guidelines, and 83.2% of them perceived that the handover was important for patients' safety. The most frequent cause for errors related to handover was that the "nursing workload is heavy." The nurses perceived that their handover was informative ($5.62{\pm}0.79$) and efficient ($5.04{\pm}0.98$). The variables associated with their perception of the handover were the level of satisfaction with the current handover method, existence of handover guidelines, and importance of handover for patient safety. Conclusion: The development of standardized handover guidelines, especially for intensive care units, is necessary to reduce handover time and errors and to improve handover quality for patients'safety and high standards of nursing care.