• Title/Summary/Keyword: Quality of Health Care

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Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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The Change in Quality of the Labor Force and Its Effect on the Economic Growth of Korea (한국 노동력의 질적향상이 경제발전에 미치는 영향)

  • Song, Wi-sup
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.159-184
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    • 1988
  • Race and ethnicity are important factors which influence the elderIy's residential adjustment behaviors, although it is unclear whether this reflects influences unrelated to race and ethnlcity. Culturally, the norm of family supportoften obseved among various minority ethnic groups is likely to provide flexible family suppof for the elderIy. Economically, the life-long hardship ofminority groups is likely to force them to maintain extended family living arrangements simply to reduce expenses via economies of scale. Thecontroversy about the economic need versus the cultural prescription forextended living arrangements remains unresoIved because it fails to articulatethe meaning of family supports among many disadvantaged groups.This study aims to test previous economic and cultural arguments, byexamining ethnic differences iu the eiderIy's responsiveness to their health andeconomic problems. Two hypotheses about cultural influences on the elderly's resideutiai adjustment are examined. First, do elderly minorities receive famiiysupporis for longer periods when they are poor if economic and health status\ulcorner Second, do elderiy minorities receive family supports more often when their health status declines\ulcorner Using the Longitudinal Suvey on Aging from 1984 to 1990. this study employs Markovian multi-state life tables, and discrete and contonuous competing hazard analyses for the transition in living arrangements. The main results provide substantial evidence against the cultural resource thesis. Elderly minorities experience more frequent transition between living alone and living with relatives than white elderly persons when group differences in the extent of mortality and insititutionalization are controlled. The shorter timf of living alone among elderly monorities stems from their greater likehood of joining relatives as well as greater mortality and attrition rates than elderly whites. Coresidence of elderly whites with their relatives is more likely to occur in response to their needs for health care than of elderly whites. it implies that instability. not flezibility. characterrizes elderly minorities living arrangements.

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A Review of the Systemic Analysis Method on Dental Sedation for Children (소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰)

  • An, Soyoun;Lee, Jewoo;Kim, Seungoh;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.331-339
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    • 2015
  • The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

Application of Patient Safety Indicators using Korean National Hospital Discharge In-depth Injury Survey (퇴원손상심층자료를 이용한 환자안전지표의 적용)

  • Kim, Yoo-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2293-2303
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    • 2013
  • Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

Comparison of Treatment Outcome Assessment for Class I Malocclusion Patients: Peer Assessment Rating versus American Board of Orthodontics-Objective Grading System

  • Hong, Mihee;Kook, Yoon-Ah;Baek, Seung-Hak;Kim, Myeng-Ki
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.6-15
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    • 2014
  • Purpose: The purpose of this retrospective study is to investigate the degree of coincidence between the peer assessment rating (PAR) index and American Board of Orthodontics objective grading system (ABO-OGS) in the assessment of orthodontic treatment outcomes of Class I malocclusion cases. Materials and Methods: The sample consisted of 26 Class I patients. The PAR index was used for evaluation of pre-(T0) and posttreatment (T1) casts, and the ABO-OGS for assessment of T1 casts. If there was a reduction in PAR scores from T0 to T1 of more than 30%, the label 'PAR+' was given to the case, and if not, it was labeled 'PAR-'. If the ABO-OGS was less than 27, the label 'OGS+' was given to the case and if not, it was labeled 'OGS-'. 'A PAR-only qualified group' (PAR+), 'ABO-OGS-only qualified group' (OGS+), 'both indices qualified group' (PAR+/OGS+), and 'both indices disqualified group' (PAR-/OGS-) were compared with a Wilcoxon rank-sum test, sensitivity/specifi city test and Spearman's correlation test. Result: PAR scores for T0, T1, and percentage reduction were 21.1, 6.4, and 65.9%, respectively, and 35.4 for ABOOGS. The distribution of the 'PAR+/OGS+', 'PAR+', and 'PAR-/OGS-' group was 19.3%, 76.9%, and 3.8%, respectively. The T0-PAR, T1-PAR and PAR point reductions for the 'PAR+' group were significantly higher than those of 'PAR+/OGS+' groups (23.1 vs. 15.6; 6.7 vs. 4.6; and 16.5 vs. 11.0; all P<0.05). However, the PAR-percentage reduction and treatment duration between the two groups were not statistically different (70.0% vs. 67.0%, P=0.4325; 24.1 months vs. 25.0 months, P=0.4057). The T1-ABO-OGS score for 'PAR+' group was significantly higher than that of the 'PAR+/OGS+' groups (38.2 vs. 24.0, P<0.001). Conclusion: Since the fraction of the 'PAR+/OGS+' group was less than 20% and there was no significant correlation between PAR-percentage reduction and T1-ABO-OGS, development of a new index system for the accurate evaluation of treatment outcome is needed.

Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City (대구지역 소아청소년과 의사들의 요로감염 관리 실태분석)

  • Lee, Sang Su;Kang, Seok Jeong;Lee, Jae Min;Cho, Min Hyun;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.95-101
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    • 2012
  • Purpose: Recently, many evidence-based guidelines for the management of urinary tract infection (UTI) have been developed because of the importance of proper management. However, there is a lack of data regarding how pediatricians manage UTIs in Korea. Therefore, we surveyed pediatricians to determine whether they manage UTIs in an appropriate manner. Methods: A postal questionnaire survey of 78 pediatricians practicing in Daegu city was performed. Subjects were asked about diagnosis, imaging studies, treatment, and prevention of UTIs. Results: Most of the respondents (94.8%) performed urinalysis to diagnose UTI in febrile children with an unknown fever focus. However, many preferred inaccurate collection methods, such as bagged urine collection, and did not obtain urine cultures. The most frequently performed imaging modality was renal-bladder ultrasonogram. Orally administered antibiotics were preferred unless admission was needed. After diagnosis of UTI, the pediatricians usually provided information to caregivers about the disease itself and supplementary treatment. Of the respondents, only 28.6% had their own guidelines for management of vesicoureteral reflux. Conclusion: Most pediatricians suspected UTI in febrile children with an unknown focus appropriately. Nevertheless, the fact that many pediatricians preferred inaccurate urine collection methods and did not perform sufficient imaging studies to detect associated abnormalities likely resulted in overtreatment due to false-positive diagnosis of UTI and a low probability of ruling out genitourinary anatomical problems. To improve the quality of management of UTI, pediatricians should follow scientific and evidence-based guidelines.

Changes in the Quality of Pork Patties during Frozen Storage on the Addition of Red Wine (돈육 패티에 첨가된 적포도주가 동결 저장 중 품질에 미치는 영향)

  • Youn, Dong-Hwa;Park, Kyung-Sook;Yang, Jong-Beom;Moon, Yoon-Hee;Lee, Kyung-Soo;Jung, In-Chul
    • Journal of the East Asian Society of Dietary Life
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    • v.17 no.2
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    • pp.234-241
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    • 2007
  • The aim of this study was to investigate the effects of the addition of red wine of pork patties during frozen storage on their water holding capacity, thawing loss, cooking loss, diameter change, thickness change, surface color, pH, VBN (volatile basic nitrogen) and TBARS (2-thiobarbituric acid reactive substances). Four types of pork patty were prepared; pork patty without red wine (control), and with the addition of 1%, 3% and 5% red wine (RWP-1, 3 -and t respectively). The pork patties were stored for 5 months at $-20^{\circ}C$. The water holding capacity was significantly decreased during frozen storage, which was not influenced by the addition of red wine (p<0.05). The thawing loss and cooking loss were significantly increased during frozen storage, which also was not influenced by the addition of red wine (p<0.05). There were no significant differences in the diameter and thickness changes during frozen storage, which was not influenced by the addition of red wine (p<0.05). There were no significant differences in the $L^*\;and\;b^*$ values, but the a value was significantly decreased during frozen storage. The $L^*,\;a^*\;and\;b^*$ values of the pork patties containing red wine were lower than those of the control patties (p<0.05). There were no significant differences in the pH and VBN content during the frozen storage period or on the addition of red wine to the patties. The TBARS value of the pork patties tended to increased with increasing in frozen storage period, but were decreased with increasing amount of red wine addition (p<0.05).

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A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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Research Methods on Scalp and Hair Management through the Pass of Time (시대적 흐름에 따른 두피와 모발관리에 대한 연구방법)

  • Kim Myung-Joo;Baek Seung-Hwa
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.123-132
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    • 2003
  • It is considered to be important to create aesthetically beautiful style through the change of external shape, however for the hair stylists, whose beauty expression is through hair, the role of hair doctor is becoming even more important with focus to improve the hair healthiness. Hair clinic is management of hair and scalp. It is the management process of preventing damages, while improving and cultivating healthy and shiny hair. The current concept in hair management is moving from simple hair styling to emphasis at hair management. As far as hair management is concerned, it usually includes treatment tools such as shampoo, conditioner, hair treatment and scalp scaling system, which is used for diagnosis of hair condition in order to treat the scalp. As the interest of hair healthiness becoming more wide spread, so does the breadth of clinic menu. The wide choice is to fulfill the profound desire of people, whose demands are simply to have variety in their choice. This is resulting in faucets of new value-added and differentiated products. The values that make-up the hair styles consist of mainly design (trend, preference), function(styling, management convenience) and clinic(hair quality improvement, damage repair). Shampoo and conditioner have gone beyond their original function of cleansing to providing combinational functions of treatment, to care and remedy, and advanced massage effectiveness. These are, to name a few that seem to go beyond their original function to satisfy the mental healthiness in people, the King Kong shampoo of shampooings in forward-backward manner, 5-minute shampoo massage that applies sports and relaxation massage, scalp acupunctural message and aural(ear) massage. More and more people are complaining about the damaged hair and hair loss problems due to perms, dyeing and bleaching of hair, in addition to natural scalp and hair damaging factors. Such complaints have stimulated many beauty products and various hair treatment systems being introduced with focus to provide nutrition and prevent damages to scalp and hair. As the living standards improve and the desire of people is to pursue differentiated lives, their demand also increases in hair styling products to fulfill the needs of healthy and aesthetical aspects of their lives.

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The Influence of Early Childhood Preservice Teachers' Aptitude of ChildCare Teacher on their Perception of Teacher Professionalism (예비보육교사의 보육교사 적성이 교사전문성 인식에 미치는 영향)

  • Kim, Young-Tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.317-324
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    • 2019
  • The purpose of this study is to find how the childcare teacher aptitude of students majoring in childcare and education influences their perception of teacher professionalism. To achieve that, a questionnaire survey was conducted with 216 early childhood preservice teachers living in A city. For data processing and analysis, SPSS program was used so as to conduct frequency analysis and calculate the mean and standard deviation. In addition, to test reliability and find relations between variables, Cronbach's ${\alpha}$, correlation analysis, and multiple regression analysis were conducted. As a result, firstly, in terms of the childcare teacher aptitude perceived by the students majoring in childcare and education, they highly perceived an affinity with young children and a sense of calling of their job; in terms of their perception of teacher professionalism, they highly perceived social necessity and vocational ethics. Secondly, early childhood preservice teachers' childcare teacher aptitude had a statistically significant correlation with their perception of teacher professionalism. Thirdly, the sub factors of early childhood preservice teachers' childcare teacher aptitude all positively influenced the sub factors of the perception of teacher professionalism. Given the study results, the students majoring in childcare and education perceived the importance of their aptitude of childcare teacher. In order to provide high-quality childcare service and create the positive aptitude of childcare teacher, it will be necessary to conduct a variety of basic research.